Abstract
OBJECTIVES: To determine the relationship between falls and deficits in specific cognitive domains in older adults.
DESIGN: An analysis of the English Longitudinal Study of Ageing (ELSA) cohort
SETTING: United Kingdom Community-Based
PARTICIPANTS: 5197 community-dwelling older adults recruited to a prospective longitudinal cohort study.
MEASUREMENTS: Data on the occurrence of falls and number of falls which occurred during a 12-month follow-up period were assessed against the specific cognitive domains of memory, numeracy skills, and executive function. Binomial logistic regression was performed to evaluate the association between each cognitive domain and the dichotomous outcome of falls in the preceding 12 months using unadjusted and adjusted models.
RESULTS: Of the 5197 participants included in the analysis, 1308 (25%) reported a fall in the preceding 12 months. There was no significant association between the occurrence of a fall and specific forms of cognitive dysfunction after adjusting for self-reported hearing, selfreported eyesight and functional performance. After adjustment, only orientation (odds ratio (OR): 0.80; 95% confidence intervals (CI): 0.65-0.98, p=0.03) and verbal fluency (adjusted OR: 0.98; 95% CI: 0.96-1.00; p=0.05) remained significant for predicting recurrent falls.
CONCLUSIONS: The cognitive phenotype rather than cognitive impairment per se may predict future falls in those presenting with more than one fall.
DESIGN: An analysis of the English Longitudinal Study of Ageing (ELSA) cohort
SETTING: United Kingdom Community-Based
PARTICIPANTS: 5197 community-dwelling older adults recruited to a prospective longitudinal cohort study.
MEASUREMENTS: Data on the occurrence of falls and number of falls which occurred during a 12-month follow-up period were assessed against the specific cognitive domains of memory, numeracy skills, and executive function. Binomial logistic regression was performed to evaluate the association between each cognitive domain and the dichotomous outcome of falls in the preceding 12 months using unadjusted and adjusted models.
RESULTS: Of the 5197 participants included in the analysis, 1308 (25%) reported a fall in the preceding 12 months. There was no significant association between the occurrence of a fall and specific forms of cognitive dysfunction after adjusting for self-reported hearing, selfreported eyesight and functional performance. After adjustment, only orientation (odds ratio (OR): 0.80; 95% confidence intervals (CI): 0.65-0.98, p=0.03) and verbal fluency (adjusted OR: 0.98; 95% CI: 0.96-1.00; p=0.05) remained significant for predicting recurrent falls.
CONCLUSIONS: The cognitive phenotype rather than cognitive impairment per se may predict future falls in those presenting with more than one fall.
| Original language | English |
|---|---|
| Pages (from-to) | 1491-1498 |
| Number of pages | 8 |
| Journal | International Psychogeriatrics |
| Volume | 31 |
| Issue number | 10 |
| Early online date | 7 Dec 2018 |
| DOIs | |
| Publication status | Published - Oct 2019 |
Bibliographical note
The ELSA was developed by researchers based at University Colleague London, the Institute of Fiscal Studies and the National Centre for Social Research. Dr Smith was supported by the National Institute for Health Research (NIHR) Oxford BiomedicalResearch Centre (BRC). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.
Keywords
- memory
- executive function
- cognitive skills
- fall
- injury
- aged