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A new perspective in predicting fall risk in non-parkinsonian geriatric patients: the magnetic resonance parkinsonism index
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DOI：10.1186/s12877-026-08112-3.png)
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Abstract
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Falls are a major geriatric syndrome associated with significant morbidity and mortality in older adults. The Magnetic Resonance Parkinsonism Index (MRPI) is a neuroimaging biomarker reflecting brainstem structural alterations; however, its role in fall risk among non-parkinsonian older adults remains unclear. This study aimed to determine whether the MRPI is independently associated with recurrent falls in older adults. This retrospective cross-sectional study included 250 adults aged ≥ 65 years who underwent brain magnetic resonance imaging (MRI) and comprehensive geriatric assessment. Participants were categorised as fallers and non-fallers. MRPI values were calculated using segmentation-based measurements from three-dimensional T1-weighted MRI. Logistic regression models were used to evaluate the independent association between MRPI and recurrent falls after adjustment for potential confounders. A total of 250 participants (171 women, 79 men) were included, of whom 103 (41.2%) had recurrent falls. MRPI values were higher in fallers than in non-fallers (13.22 vs. 12.74, p = 0.027). The MRPI was positively correlated with age, number of falls, number of medications, Timed Up and Go test time, and frailty, whereas it was negatively correlated with the Tinetti Performance-Oriented Mobility Assessment score, grip strength, and functional status (p < 0.05). The MRPI was independently associated with falls across all multivariable models, including the fully adjusted model (odds ratio, 1.61; 95% confidence interval, 1.02–2.48; p = 0.031). The MRPI is independently associated with falls in non-parkinsonian older adults and may represent a novel neuroimaging biomarker for fall risk prediction.
Keywords:
Geriatric syndromes
Recurrent falls
Magnetic resonance parkinsonism index
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