Simple risk factors can help identify people with mild cognitive impairment who have a higher probability of falling, according to the results of a new JAMDA study.
The inability to independently complete activities of daily living was the greatest fall risk factor in individuals with MCI, according to French researchers using data from a cohort of 1,416 older adults. They found that individuals with MCI who had frequent falls performed lower in executive function, balance and gait tests. Age, gender and living alone, also were significantly associated with falls in individuals with MCI.
Fallers in the study tended to be shorter in stature than non-fallers, potentially reflecting osteoporosis and/or postural changes, the researchers noted.
The study findings also revealed that the association between cognitive impairment and the risk of falls varied with the severity of impairment. Fall risk factors in individuals living with dementia were similar to their healthy counterparts — previous falls, depression and symptomatic orthostatic hypotension.
Past studies have shown that in people with MCI, risk factors for falling included lower muscle strength, living alone and depression. The French study, however, found that independent ADL limitations, not physical measures, were most associated with falling.
Although identifying and correcting fall risk factors, physical exercise and diet have been shown to reduce the risk of falls in community-dwelling older adults, the investigators noted that little research has looked into the effects of falls prevention interventions in cognitively impaired individuals. Given the high prevalence of falls and poor outcomes in older adults with cognitive impairment, the researchers said that a need exists to better identify high-risk individuals to target for falls prevention interventions.
The findings suggested that sociodemographic factors and executive function disorders in adults aged 75 or more years could be used to target those with MCI who are at risk for falls. The authors suggested that future studies could compare fall risk factors in older adults with MCI with those with dementia.
“By targeting high-risk patients specifically, prevention strategies might lead to better outcomes,” the authors stated.
