Abstract
Background
Fear of falling (FoF) is present in 20% to 85% of older adults and may be an early
marker of decline in global cognitive functioning (GCF). We tested the hypothesis
that FoF is associated with lower levels of GCF (cross-sectional) and greater decline
in GCF (prospective) in adults aged 50 and older.
Design
Observational cohort study.
Setting
The Irish Longitudinal Study on Ageing, a population-based study.
Participants
Data were from 4931 participants (mean age 62.9 ± 9.1, range 50–98, 54.3% female).
Measurements
FoF was based on self-report in 2010. GCF was measured with the Montreal Cognitive
Assessment (MoCA) and Mini Mental Status Examination (MMSE) in 2010 and 2014. The
cross-sectional association was examined using linear regression unadjusted and after
adjustment for demographic and health factors. The prospective association between
FoF and the odds of >1-SD decline in GCF were examined using logistic regression.
Interaction with age and mediation by social and physical activities were examined.
Results
In 2010, 21.9% of participants reported FoF. In the unadjusted cross-sectional models,
those with FoF had lower scores on the MoCA (B −1.15, 95% confidence interval [CI] −1.40
to −0.90) and MMSE (B −0.52, CI −0.67 to −0.37). In the unadjusted prospective models,
FoF was associated with a greater odds of decline in MoCA (odds ratio [OR] 1.60, CI
1.26–2.04) and MMSE (OR 1.64, CI 1.29–2.08). After adjustment for covariates, all
associations attenuated and were no longer statistically significant, except the association
with decline in MoCA (OR 1.32, CI 1.01–1.71). No statistically significant interaction
with age was found (P > .37). Additional adjustment for social and physical activity did not change the
results.
Conclusions
The findings provide weak evidence for FoF as a predictor of cognitive decline.
Keywords
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Article info
Publication history
Published online: November 03, 2017
Footnotes
The authors declare no conflicts of interest.
The Irish Longitudinal Study on Ageing is funded by the Irish Government, the Atlantic Philanthropies, and Irish Life PLC. G.P. was supported by a Global Brain Health Institute fellowship.
Identification
Copyright
© 2017 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
