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Risk factors for falls in community-dwelling older people with mild cognitive impairment: a prospective one-year
Thanwarat Chantanachai1,2, Morag E Taylor1,3, Stephen R Lord1,4
1Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia.
Objective:
Mild cognitive impairment (MCI) is considered an intermediate stage between normal cognitive function and dementia. Fall risk is increased in this group, but there is limited literature exploring specific fall risk factors that may be addressed in fall prevention strategies. The aim of this study was to examine risk factors for falls in older people with MCI, focusing on cognitive, psychological and physical factors.
Methods:
Participants (n = 266, 45% women) were community-dwelling older people aged 70-90 years who met the criteria for MCI. Cognitive, psychological, sensorimotor and physical assessments, physical activity levels, medication use, general health and disability were ascertained at baseline. Falls were monitored prospectively for 12 months.
Results:
During follow-up, 106 (40%) participants reported one or more falls. Poorer visual contrast sensitivity, increased postural sway, lower levels of weekly walking activity, higher levels of depressive symptoms and psychotropic medication use were significantly associated with faller status (≥1 falls) in univariable analyses. Of these factors, poor visual contrast sensitivity, increased postural sway and psychotropic medication use were found to be significant independent predictors of falls in multivariable analysis while controlling for age and sex. No measures of cognitive function were associated with falls.
Conclusions:
Poor visual contrast sensitivity, impaired balance and psychotropic medication use predicted falls in community-dwelling people with MCI. These risk factors may be amenable to intervention, so these factors could be carefully considered in fall prevention programs for this population.
Insights
Older adults with mild cognitive impairment (MCI) who have poor vision, balance issues, or use psychotropic medications are at higher risk for falls. These factors can inform targeted fall prevention strategies for this population.
Area of Science:
- Gerontology
- Neurology
- Public Health
Background:
- Mild cognitive impairment (MCI) represents an intermediate stage between normal cognition and dementia.
- Individuals with MCI exhibit an increased risk of falls, yet specific, modifiable risk factors require further investigation for effective prevention.
- Understanding these factors is crucial for developing targeted interventions to reduce fall incidence in this vulnerable population.
Purpose of the Study:
- To investigate cognitive, psychological, and physical risk factors associated with falls in community-dwelling older adults with MCI.
- To identify specific predictors of falls that can be targeted for fall prevention strategies.
Main Methods:
- A prospective study involving 266 community-dwelling older adults (aged 70-90) diagnosed with MCI.
- Comprehensive baseline assessments included cognitive, psychological, sensorimotor, and physical function, activity levels, medication use, and general health.
- Falls were prospectively monitored over a 12-month period.
Main Results:
- 40% of participants reported at least one fall during the 12-month follow-up.
- Univariable analyses indicated associations between faller status and poorer visual contrast sensitivity, increased postural sway, lower walking activity, depressive symptoms, and psychotropic medication use.
- Multivariable analysis identified poor visual contrast sensitivity, increased postural sway, and psychotropic medication use as independent predictors of falls, independent of cognitive function measures.
Conclusions:
- Poor visual contrast sensitivity, impaired balance (indicated by postural sway), and psychotropic medication use are significant predictors of falls in older adults with MCI.
- These identified risk factors are potentially amenable to intervention, suggesting their importance in designing fall prevention programs for individuals with MCI.
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