Introduction Alzheimer's disease (AD), found in the aging elderly population, is a progressive neurodegenerative disorder that leads to worsening memory loss and cognitive impairment. Falls and fractures are common in the overall elderly population. Hence, the purpose of this study is to determine the prevalence of falls and fractures in Alzheimer's patients compared to the general population. Methodology This longitudinal study was conducted at the neurology outpatient department (OPD) in a tertiary healthcare setup in Pakistan from November 2019 till April 2020. Previously confirmed diagnosed Alzheimer's patients from neurology OPD were included in one group. Equal number of gender and agematched healthy participants were included in the reference group. Participants were followed for 12 months to determine the incidence of falls and non-vertebral fractures. Results The incidence of fall was significant in the Alzheimer group compared to the reference group (22.8% vs. 10.9%; relative risk (RR): 2.08; P-value: 0.01). Fractures were also significantly more common in the Alzheimer group compared to the reference group (12.8% vs. 5.1%; RR: 2.51; P-value: 0.03). Conclusion This study demonstrated a higher incidence of falls and fractures in Alzheimer's patients compared to healthy non-Alzheimer individuals. Management of AD should include measures to reduce falls and fractures in addition to standard therapy.

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Current theory in tourism marketing lacks understanding of how businesses signal trust to consumers to make destination-based choices. The present research investigates the role of E-WOM, destination image, familiarity, and trust (as mediator) in destination choice from signaling theory perspective. The theory suggests that there is asymmetric information between the receiver and sender which can be resolved by communicating various positive signals. This study aims to test interrelationships among these variables on destination choice. A random sample of 382 consumers having experience of travelling to the northern areas of Pakistan participated in this study. Data was analyzed through SmartPLS. The research findings highlight relationship among factors which plays a significant role for destination choice. The findings further indicate that destination trust act as a positive signal for consumers which in turn influences their destination choice (consumer perceive). Furthermore, for tourists visiting northern areas of Pakistan positive E-WOM, destination image and familiarity create signals to influence destination trust. Implications of the findings for theory and practices are considered along with future research directions.