Cross-Lagged Panel Analysis between Physical Frailty, Cognitive Function, and Falls by Sex

Area of Science:

• Gerontology
• Epidemiology
• Public Health

Background:

• Physical frailty (PF) and cognitive function (CF) are significant concerns for older adults.
• Falls are a major cause of injury and mortality in the elderly population.
• Understanding the interplay between PF, CF, and falls is crucial for developing effective interventions.

Purpose of the Study:

• To investigate the reciprocal longitudinal relationships between physical frailty, cognitive function, and falls in community-dwelling older adults.
• To examine these relationships separately based on sex.
• To test the hypothesis that PF and CF predict future falls.

Main Methods:

• Secondary data analysis of the Korean Frailty and Aging Cohort Study (KFACS) waves 1 and 2.
• Inclusion of 2318 community-dwelling older adults aged 70-84 years.
• Assessment of PF using the Fried Frailty Phenotype and CF using the Korean Mini-Mental State Examination, with fall data collected.
• Multigroup cross-lagged panel analysis was employed to analyze the data.

Main Results:

• Physical frailty at baseline predicted falls two years later (β = 0.087, P < .001).
• Falls at baseline predicted physical frailty two years later (β = 0.041, P = .020).
• No significant direct relationship was found between cognitive function and falls, but PF and CF showed reciprocal longitudinal relationships (all P < .001).
• A significant longitudinal relationship between falls and PF was observed in men only (β = 0.063, P = .015).

Conclusions:

• Physical frailty is a significant predictor of future falls and vice versa in older adults.
• Cognitive function's impact on falls may be indirect, mediated through physical frailty.
• Fall prevention programs should prioritize early interventions targeting physical frailty improvement, alongside cognitive function maintenance, particularly for older men.