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When it comes to dementia and falls, which comes first? Do people with dementia fall more often, or does falling down indicate dementia?

Researchers at Johns Hopkins hope to find out. They’re conducting two studies this summer that will look at how dementia affects balance.

“The same parts of your brain that control memory play a significant role in how you maintain your balance,” said Dr. Yuri Agrawal, principal investigator of the studies and professor of Otolaryngology-Head and Neck Surgery at Hopkins’ School of Medicine.

Agrawal’s lab conducts research on the vestibular system (the inner ear’s balance system), according to its website, “and how the function of the vestibular system changes with aging. Particular focus is given to study how age-related changes in vestibular function influence mobility disability and fall risk in older individuals.”

Two-year observational study

The first study is an observational study, meaning that the subjects don’t have to do anything such as swallow pills or keep a journal.

Instead, Agrawal’s researchers will make in-home visits and keep in touch over the phone with participants for a period of two years. Participants must be 60 or older.

Agrawal has seen his staff interact successfully with many older adults, she said. “It’s engaging,” she said. “We have a lot of young study staff. They’re a great group.”

Eight weeks of balance therapy

The second trial underway this summer is one that lasts eight weeks.

Two thirds of Alzheimer’s patients fall every year, Agrawal said — that’s twice as many falls as experienced by healthy older adults.

“Falls are difficult to prevent. We want to try a new app to see if we can reduce the risk,” Agrawal said.

In this eight-week trial, researchers will determine “whether or not a specific kind of balance therapy can improve balance and prevent falls,” she said.

In this day and age, that therapy is via computer, of course — or in this case, a tablet. Agrawal’s staff will give each participant a tablet and access to wi-fi.

Anyone 60 and over with memory problems, including Alzheimer’s, is eligible to participate as long as they have someone to help them use the tablet, answer the phone, and fill out surveys.

Through the tablet, Agrawal’s team has developed some exercises called vestibular therapy, a type of physical therapy.

“We’ve made it so that it’s fully remote, because it’s hard for some people to get transportation,” she said.

Only one in-person visit to the Johns Hopkins Bayview campus or the participant’s home is required.

Agrawal’s hope is that the virtual therapy exercises can help prevent falls. “It’s an important public health issue,” she said of falls in older adults. “Right now, we’re watching and waiting. This is a more proactive approach.”

Compensation is available for participants in both studies. For more information about the two-year observational study, call (410) 614-9825. To volunteer to participate in the two-month vestibular therapy trial, call (410) 502-2145.