Effects of mild and global cognitive impairment on the prevalence of fear of falling in community-dwelling older adults

Maturitas. 2014 May;78(1):62-6. doi: 10.1016/j.maturitas.2014.02.018. Epub 2014 Mar 12.

Abstract

Objectives: Few studies have reported the relationship between fear of falling (FoF) and mild and global cognitive impairment in community-dwelling older adults. We aimed to determine whether the status of cognitive impairment affects the prevalence of FoF in community-dwelling older adults.

Study design: Cross-sectional study among 4474 community-dwelling older adults who participated in the Obu Study of Health Promotion for the Elderly.

Main outcome measures: Participants underwent cognitive tests and were divided into three groups: cognitive healthy, mild cognitive impairment (MCI), and global cognitive impairment (GCI). FoF and related variables, such as fall history, physical function, and depression, were also investigated.

Results: The prevalence of FoF was significantly different by group (p<0.001; healthy: 43.6%, MCI: 50.6%, GCI: 40.6%). Logistic regression analysis showed that GCI (odds ratio=0.63; 95% confidence interval=0.526-0.76) was independently associated with FoF, after controlling for confounding factors. Older adults with GCI showed the lowest prevalence of FoF, although they had the lowest physical function comparing with the other groups (p<0.001).

Conclusion: MCI and GCI in community-dwelling older adults affect the prevalence of FoF in a completely different manner. Further study is required to determine whether insensitivity to FoF with GCI increases the risk of falling in older adults.

Keywords: Anosognosia; Cognitive decline; Falls; Mild cognitive impairment; Mini-Mental State Examination.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls*
  • Aged
  • Aged, 80 and over
  • Cognition Disorders / psychology*
  • Cross-Sectional Studies
  • Fear*
  • Female
  • Geriatric Assessment*
  • Humans
  • Independent Living*
  • Logistic Models
  • Male
  • Odds Ratio
  • Prevalence
  • Residence Characteristics
  • Severity of Illness Index*
  • Stress, Psychological / epidemiology
  • Stress, Psychological / etiology