Physiological fall risk factors in cognitively impaired older people: a one-year prospective study

Dement Geriatr Cogn Disord. 2012;34(3-4):181-9. doi: 10.1159/000343077. Epub 2012 Oct 11.

Abstract

Background/aims: Cognitively impaired older people are at twice the risk of falls compared to cognitively intact, with approximately 60% falling once or more per year. This study aimed to investigate sensorimotor and balance risk factors for falls in cognitively impaired older people.

Methods: 177 community-dwelling older people with mild to moderate cognitive impairment (Mini-Mental State Examination < 24, Addenbrooke's Cognitive Examination-Revised < 83) were assessed using the Physiological Profile Assessment (PPA). Falls were recorded prospectively for 12 months using monthly calendars with the assistance of carers.

Results: Seventy-one participants (43%) fell ≥2 times in the follow-up period. Impaired simple reaction time, postural sway, leaning balance and increased PPA fall risk score were significantly associated with multiple falls. The area under the receiver-operating characteristic curve for the PPA model including tests of vision, proprioception, knee extension strength, reaction time, postural sway and leaning balance was 0.75 (95% confidence interval: 0.68-0.83).

Conclusion: These findings indicate poor performance on physiological fall risk factors, particularly balance, increases the risk of falls in older cognitively impaired people.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls*
  • Aged
  • Aged, 80 and over
  • Area Under Curve
  • Cognition Disorders / complications*
  • Cognition Disorders / physiopathology
  • Dementia / complications*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Postural Balance / physiology*
  • Prospective Studies
  • Reaction Time / physiology*
  • Regression Analysis
  • Residence Characteristics
  • Risk Assessment
  • Risk Factors