Examining the effect of the relationship between falls and mild cognitive impairment on mobility and executive functions in community-dwelling older adults.
March 20, 2015
J Am Geriatr Soc. 2015 Mar;63(3):590-3. doi: 10.1111/jgs.13290.
Cognitive impairment and falls are geriatric “giants” that significantly increase morbidity and mortality in older adults. Even mild cognitive impairment (MCI) is a significant risk factor for falls. Clinical gait abnormalities including slow gait and falls are early biomarkers of cognitive impairment, suggesting that impaired cognitive function and mobility share common underlying pathophysiology.
Despite the vast interest in the interplay between impaired cognitive function and mobility, few studies to date have investigated whether their co-manifestation results in a broader and greater degree of deficits, potentially due to greater burden of pathology, than singular domain (i.e., cognitive or mobility) impairment. Understanding the specific and extent of deficits may facilitate the development of effective screening and prevention strategies. Therefore, we examined the independent and synergistic effects of: 1) MCI status as defined by a Montreal Cognitive Assessment (MoCA) score < 26/30 and; 2) fall status (i.e., ≥ 2 falls is a faller, ≤ 1 fall is a non-faller) on measures of cognitive function and mobility over a 12-month period. For cognitive function, we focused on executive functions as they are highly associated with impaired mobility, including falls.
We conducted a 12-month prospective study (baseline and 12 months) with 149 women and men, aged 70to 80 years; 2) with ≥ 24/30 Mini-Mental State Examination (MMSE) scores;4 and 3) living independently in their own homes.
Our study highlights that the combination of positive MCI and fall status may be a significant risk profile for future deterioration in mobility. MCI alone is a more important predictor of concurrent executive deficits than fall status. Future research should further explore the unique and synergistic effects of falls and MCI as “early” indicators of future decline in mobility and executive function in order to accurately tailor future intervention and prevention strategies for men and women.