The fall-dementia connection: Synergistic effects of falls with genetic and health risk factors
Zhongxuan Wang, Qi Wang, Chunying Fu, Xiang Li, Luyi Zhang, Xiaoyu Zhang, Dongshan Zhu. Journal of Alzheimer s Disease, 2025-05-05
Topic: Risk, prevention and care in population studies
Background Few studies have examined the inverse relationship between dementia and falls, i.e., whether falls before dementia are a herald of dementia. Objective We aimed to explore the relationship between fall experiences and risk of dementia, assessing how factors like APOE ε4 allele, family history of dementia, comorbidities, traumatic brain injury (TBI), and frailty modify this association. Methods We used data from the UK Biobank. We used Cox proportional hazards models to estimate the HRs and 95% CIs for the association between falls and all-cause dementia, Alzheimer's disease (AD), vascular dementia (VaD), and non-Alzheimer/non-vascular dementia (NAVD). The synergistic effects of fall experiences and APOE , dementia family history, cardiovascular disease (CVD), diabetes, TBI, frailty on dementia were also investigated. Results Totally, 403,502 participants were included. 99,832 people experienced at least one fall, and 4143 dementia cases were observed. People who experienced falls had a higher risk of all-cause dementia, AD, VaD, and NAVD, with HRs (95% CIs) of 1.71(1.61, 1.83), 1.33 (1.20, 1.47), 2.00 (1.74, 2.29), and 2.03 (1.84, 2.24), respectively. The risk of dementia increased with the number of falls and with falls occurring later in life (after age 60). Fall experiences had a synergistic effect with dementia risk factors ( APOE ε4 allele, family history of dementia and comorbidities), TBI, and frailty, collectively increasing the risk of dementia. Conclusions Falls before dementia were linked to a higher risk of dementia. The risk escalated with more falls and falls after age 60. Combining falls with risk factors further amplified dementia risk.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Wang, Z., Wang, Q., Fu, C., Li, X., Zhang, L., Zhang, X., et al. (2025). The fall-dementia connection: Synergistic effects of falls with genetic and health risk factors. Journal of Alzheimer s Disease. https://doi.org/10.1177/13872877251333799
Vancouver
Wang Z, Wang Q, Fu C, Li X, Zhang L, Zhang X, et al. The fall-dementia connection: Synergistic effects of falls with genetic and health risk factors. Journal of Alzheimer s Disease. 2025. doi:10.1177/13872877251333799. PMID: 40325974.
BibTeX
@article{wang2025-40325974,
author = {Wang, Zhongxuan and Wang, Qi and Fu, Chunying and Li, Xiang and Zhang, Luyi and Zhang, Xiaoyu and Zhu, Dongshan},
title = {{The fall-dementia connection: Synergistic effects of falls with genetic and health risk factors}},
journal = {Journal of Alzheimer s Disease},
year = {2025},
doi = {10.1177/13872877251333799},
pmid = {40325974},
url = {https://doi.org/10.1177/13872877251333799}
}
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Key findings
- Results Totally, 403,502 participants were included. 99,832 people experienced at least one fall, and 4143 dementia cases were observed.
- People who experienced falls had a higher risk of all-cause dementia, AD, VaD, and NAVD, with HRs (95% CIs) of 1.71(1.61, 1.83), 1.33 (1.20, 1.47), 2.00 (1.74, 2.29), and 2.03 (1.84, 2.24), respectively.
- Conclusions Falls before dementia were linked to a higher risk of dementia.
Why it matters
In this UK Biobank study of over 400,000 participants, people who experienced falls had higher risks of all-cause dementia, Alzheimer disease, vascular dementia, and non-Alzheimer/non-vascular dementia. Fall experiences had synergistic effects with dementia risk factors including the APOE ε4 allele, family history of dementia, and frailty.
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Study details
- Participants403,502
- Evidence strengthLow
How this study scored 40/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Alzheimer s Disease) |
| Journal's citation record | 2 / 4 | Journal of Alzheimer s Disease: journal h-index 218 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 4 / 4 | 403,502 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 4 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 2.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Dongshan Zhu: h-index 22 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Shandong University: institution h-index 615 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40325974) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 40 / 100 | — |
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