Association of Fear of Falling With Cognition and Physical Function in Community-Dwelling Older Adults

Fear of falling (FOF) might be associated with physical and cognitive function, but there is a lack of understanding of the specific relationship between the three variables.

The aim of this study was to accurately investigate the association of FOF with cognitive and physical function in community-dwelling older adults.

Six hundred sixty-nine older adults (>60 years old) participated in this study. A self-report questionnaire collected information about demographic characteristics, lifestyle, and behavioral habits. FOF was evaluated through the Shortened Version of the Falls Efficacy Scale International. Global cognitive function and the subdomains of cognitive function (including memory, visual-spatial, language, attention, and executive function) were assessed using the Montreal Cognitive Assessment scale, the Auditory Verbal Learning Test, the Clock Drawing Test (CDT), the Verbal Fluency Test, and the Trail Making Test. Subjective memory complaints were assessed using the Subjective Memory Complaints Questionnaire. Physical function was evaluated by measuring muscle strength and balance ability, and muscle strength was indicated by hand grip strength. In contrast, balance was assessed using the Timed Up and Go (TUG) Test.

After adjustment for potential confounding factors, the linear or ordinal regression analysis showed that the values of hand grip strength, Montreal Cognitive Assessment, Auditory Verbal Learning Test, and CDT were significantly and negatively correlated with the score of FOF. On the other hand, Subjective Memory Complaints Questionnaire and TUG Test values showed significant positive correlations with FOF scores. Moreover, compared with other cognitive or physical measures, the CDT and TUG Test values showed a greater association with the FOF scores.

Low subjective or objective cognitive ability and low physical function, especially low visuospatial and balance ability, were positively associated with the risk of FOF in a community-dwelling older population.