The aim of this study was to determine whether mild cognitive impairment (MCI) affects the development of fear of falling (FoF) in older adults.
Prospective cohort study.
The Obu Study for Health Promotion in the Elderly, Japan.
A total of 1700 community-dwelling people aged 65 years or older without FoF at baseline participated.
FoF and related variables, such as physical function, self-rated health, depression, and total number of medication doses, were investigated at baseline. Participants also underwent cognitive tests and were divided into cognitive healthy and MCI. Fifteen months after the baseline measurements, we collected information about the status of FoF and fall incidence during the 15-month follow-up.
At the 15-month follow-up survey, 452 participants (26.5%) reported the development of FoF. Logistic regression analysis showed that MCI (odds ratio [95% CI] = 1.41 [1.07–1.87]) and a fall incident (3.00 [2.23–4.07]) during follow-up independently predicted the development of FoF, after controlling for demographic factors, physical function, self-rated health, and depression. The odds ratio for the development of FoF in participants with both MCI and a fall incident compared with those without them was 7.34 (4.06–13.3), after controlling for confounding factors.
MCI predicts the new onset of FoF in older adults, especially when they have experience with falling. Aside from the risk of falling, it is suggested that individuals with MCI are an at-risk population for FoF and related negative consequences in terms of postfall syndrome.
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- Fear of falling in older women: A longitudinal study of incidence, persistence, and predictors.J Am Geriatr Soc. 2007; 55: 1598-1603
- Effects of mild and global cognitive impairment on the prevalence of fear of falling in community-dwelling older adults.Maturitas. 2014; 78: 62-66
- The development of fear of falling among community-living older women: Predisposing factors and subsequent fall events.J Gerontol A Biol Sci Med Sci. 2003; 58: M943-M947
- Activity restriction induced by fear of falling and objective and subjective measures of physical function: A prospective cohort study.J Am Geriatr Soc. 2008; 56: 615-620
- Fear of falling: Measurement strategy, prevalence, risk factors and consequences among older persons.Age Ageing. 2008; 37: 19-24
- Fear of falling in patients with hip fractures: Prevalence and related psychological factors.J Am Med Dir Assoc. 2013; 14: 218-220
- Quality of life related to fear of falling and hip fracture in older women: A time trade off study.BMJ. 2000; 320: 341-346
- Mild cognitive impairment as a predictor of falls in community-dwelling older people.Am J Geriatr Psychiatry. 2012; 20: 845-853
- Gait and cognition: A complementary approach to understanding brain function and the risk of falling.J Am Geriatr Soc. 2012; 60: 2127-2136
- Current concepts in mild cognitive impairment.Arch Neurol. 2001; 58: 1985-1992
- Behavioral symptoms in mild cognitive impairment as compared with Alzheimer's disease and healthy older adults.Int J Geriatr Psychiatry. 2013; 28: 265-275
- A systematic review of neuropsychiatric symptoms in mild cognitive impairment.J Alzheimers Dis. 2009; 18: 11-30
- Neuropsychiatric manifestations in mild cognitive impairment: A systematic review of the literature.Dement Geriatr Cogn Disord. 2008; 25: 115-126
- Anxiety and behavioural disturbance as markers of prodromal Alzheimer's disease in patients with mild cognitive impairment.Int J Geriatr Psychiatry. 2011; 26: 166-172
- Interventions to reduce fear of falling in community-living older people: A systematic review.J Am Geriatr Soc. 2007; 55: 603-615
- Mild cognitive impairment as a diagnostic entity.J Intern Med. 2004; 256: 183-194
- Evaluation of multidimensional neurocognitive function using a tablet personal computer: Test-retest reliability and validity in community-dwelling older adults.Geriatr Gerontol Int. 2013; 13: 860-866
- Development of a common outcome data set for fall injury prevention trials: The Prevention of Falls Network Europe consensus.J Am Geriatr Soc. 2005; 53: 1618-1622
- The timed “Up & Go”: A test of basic functional mobility for frail elderly persons.J Am Geriatr Soc. 1991; 39: 142-148
- Geriatric Depression Scale.Psychopharmacol Bull. 1988; 24: 709-711
- Mortality in elderly men and women in a Swedish municipality.Age Ageing. 1998; 27: 585-593
- Falls and fear of falling: Which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention.J Am Geriatr Soc. 2002; 50: 1329-1335
- Fear of falling and gait variability in older adults: A systematic review and meta-analysis.J Am Med Dir Assoc. 2015; 16: 14-19
- Incidence and risk factors for developing fear of falling in older adults.Public Health Nurs. 2005; 22: 45-52
- Fear of falling in new long-term care enrollees.J Am Med Dir Assoc. 2007; 8: 307-313
- Prevalence of sarcopenia in community-dwelling Japanese older adults.J Am Med Dir Assoc. 2013; 14: 911-915
- Motor dysfunction in mild cognitive impairment and the risk of incident Alzheimer disease.Arch Neurol. 2006; 63: 1763-1769
- Fear of falling.Phys Ther. 2002; 82: 264-272
- Life space and risk of Alzheimer disease, mild cognitive impairment, and cognitive decline in old age.Am J Geriatr Psychiatry. 2011; 19: 961-969
- Exercise is associated with reduced risk for incident dementia among persons 65 years of age and older.Ann Intern Med. 2006; 144: 73-81
- A randomized, controlled trial of a group intervention to reduce fear of falling and associated activity restriction in older adults.J Gerontol B Psychol Sci Soc Sci. 1998; 53: P384-P392
- Covariates of fear of falling and associated activity curtailment.Gerontologist. 1998; 38: 549-555
- Monitoring falls in cohort studies of community-dwelling older people: Effect of the recall interval.J Am Geriatr Soc. 2005; 53: 2190-2194
- Validity and sensitivity to change of the falls efficacy scales international to assess fear of falling in older adults with and without cognitive impairment.Gerontology. 2011; 57: 462-472
The authors declare no conflicts of interest.
This work was funded by a grant from the Japanese Ministry of Health, Labour, and Welfare (Project for Optimizing Long-Term Care; B-3) and a grant from the National Center for Geriatrics and Gerontology (Research Funding for Longevity Sciences; 22–16).
© 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.