By sharpening mental function, methylphenidate (Ritalin) may help older people reduce the risk of falls. After just one dose of methylphenidate, older adults participating in a small study demonstrated a more even gait and performed better on a screening test to assess fall risk.

Researchers asked 26 healthy older adults without dementia (average age 74 years) who were living independently to complete tests of mobility, fall risk, memory, and executive function (which includes mental processes needed to plan, organize, and remember details). Participants were tested before and 2 hours after taking 20 mg of methylphenidate or a placebo in sessions 1 to 2 weeks apart. They were evaluated with the Timed Up and Go test, in which a person gets up from a chair, walks 10 feet at a normal pace, turns around, and walks back to sit in the chair. Risk of falling increases with the amount of time needed to complete the test.

Participants who'd taken methylphenidate had significantly better Timed Up and Go test times, stride times (a marker of instability), and measures of executive function than those who took a placebo. Methylphenidate use didn't significantly affect memory.

Researchers say more studies are needed to confirm findings of this small study.

Source: Ben-Itzhak R, et al., Can methylphenidate reduce fall risk in community-living older adults? A double-blind, single-dose cross-over study, Journal of the American Geriatrics Society, April 2008.