Falling in elderly individuals, especially those with Alzheimer’s disease (AD), significantly increases mortality risk due to a complex interplay of cognitive decline, physical frailty, and associated complications. Alzheimer’s disease, a progressive neurodegenerative disorder characterized by cognitive impairment, also affects motor functions such as gait and balance, which are critical factors in fall risk. Falls in elderly patients with AD often lead to serious injuries, including fractures and head trauma, which can precipitate a decline in overall health and increase the likelihood of death.
Research shows that gait abnormalities—such as reduced gait speed and shorter stride length—are strongly associated with cognitive decline in dementia patients, including those with Alzheimer’s and related disorders like Dementia with Lewy bodies (DLB). These gait impairments independently predict a higher risk of falls. For example, a study found that each standard deviation decrease in gait speed increased fall risk by 33%, and a 1-cm reduction in stride length raised fall risk by 21%[1][4]. This motor-cognitive network dysfunction means that as Alzheimer’s progresses, patients become more prone to falls due to impaired coordination and executive function.
Falls in elderly patients with Alzheimer’s are particularly dangerous because of their frailty and the presence of multiple comorbidities. Frailty, a common condition in older adults characterized by decreased physiological reserves and increased vulnerability to stressors, compounds the risk of adverse outcomes after a fall. Frail elderly individuals have a higher likelihood of sustaining severe injuries and experiencing complications such as infections, prolonged immobility, and pressure ulcers, all of which contribute to increased mortality[2].
Moreover, Alzheimer’s patients often have impaired thermoregulation and cardiovascular vulnerabilities, which can exacerbate the consequences of falls. Older adults with cardiovascular disease, a leading cause of death in those over 65, are at increased risk of mortality during stress events such as falls or environmental extremes. The diminished ability to regulate body temperature and maintain cardiovascular stability can worsen outcomes after a fall, especially if hospitalization or immobilization occurs[2].
The mortality risk after a fall in Alzheimer’s patients is also influenced by the severity of the injury. Hip fractures, common in fall-related injuries, are associated with a high risk of death within one year post-fracture in elderly populations. The combination of cognitive impairment, reduced mobility, and complications from surgery or prolonged bed rest increases mortality rates significantly in this group.
In addition to physical injuries, falls can accelerate cognitive and functional decline in Alzheimer’s patients. The trauma and subsequent hospitalization can lead to delirium, increased dependency, and reduced quality of life, all factors that contribute to higher mortality. The interplay between cognitive decline and physical frailty creates a vicious cycle where falls lead to worsening health, which in turn increases fall risk.
Preventive strategies focusing on gait assessment and fall risk evaluation are crucial in managing elderly patients with Alzheimer’s. Gait analysis serves as a biomarker for both cognitive and motor decline, helping clinicians identify patients at high risk of falls and implement interventions such as physical therapy, environmental modifications, and medication review to reduce fall incidence[1][4].
In summary, falling in elderly individuals with Alzheimer’s disease markedly increases mortality risk due to the combined effects of cognitive impairment, gait abnormalities, frailty, and comorbid conditions. The consequences of falls—ranging from physical injuries to accelerated health decline—underscore the importance of early identification and prevention strategies in this vulnerable population.
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[1] Frontiers in Neurology, 2025: “Gait characteristics and factors associated with fall risk in patients with Dementia with Lewy bodies”
[2] PMC, 2023: “A framework for ageing and health vulnerabilities in a changing climate”
[4] Frontiers in Neurology, 2025: “Gait characteristics and factors associated with fall risk in patients with Dementia with Lewy bodies” (epu
