Date of Graduation

Summer 8-11-2018

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

Abstract

|| Abstract ||

Background: Approximately one-third of people aged 65 years and over who are not living in institutions fall at least once a year, with higher rates among those living in institutions. One half of older adults who are hospitalized as a result of a fall survive one year later.The importance of fall prevention in older adults is well researched, with many established community based programs in the United States focusing on exercise and fundamental education for fall reduction. However, new options for prevention are being explored. Executive function and gait, both related to falls, may be improved by methylphenidate, providing a promising option for fall prevention in older adults.

Methods: An exhaustive literature search using MEDLINE-PubMed, Web of Science, and Clinical Key was conducted. The following search terms were used: “methylphenidate falls prevention,” “methylphenidate older adults,” and “falls prevention methylphenidate.” Eligibility criteria were used to screen studies. These studies included the use of single dose methylphenidate versus placebo to measure efficacy in falls prevention. GRADE was used to assess quality of the resulting studies.

Results: Two studies were included in this systematic review, meeting the inclusion and exclusion criteria. One study was a double-blind RCT in 30 healthy older adults testing improvement of executive, motor and balance function. Another study in 26 older adults without dementia but with subjective complaints of memory problems tested the modification of markers for fall risk. These studies have medium quality of evidence based on GRADE guidelines.

Conclusion: These studies found that methylphenidate improved gait and executive function in older adults, and should be considered by clinicians as a method of fall prevention in this population. These results warrant further investigation of methylphenidate use in fall prevention with large-scale studies.

Keywords: Methylphenidate, older adults, and fall prevention

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