TY - JOUR
T1 - Cognitive function modifies the effect of physiological function on the risk of multiple falls--a population-based study
AU - Martin, Kara
AU - Blizzard, Leigh
AU - Srikanth, Velandai
AU - Wood, Amanda Gabrielle
AU - Thomson, Russell
AU - Sanders, Lauren Maree
AU - Callisaya, Michele
PY - 2013
Y1 - 2013
N2 - There is a poor understanding of the interplay between cognitive and physiological functions in leading to falls. We hypothesized that poorer physiological function would modify the effect of poorer cognitive function on increased risk of falling in older people. METHODS: A range of cognitive (executive function/attention, memory, processing speed, and visuospatial ability) and physiological functions (vision, proprioception, sway, leg strength, reaction time) were measured using standardized tests in 386 randomly selected adults aged 60-86. Incident falls were recorded over 12 months. Log-multinomial regression was used to model the relationships and test for interactions between cognition and physiological function in explaining the risk of single or multiple falls. RESULTS: Overall, 94 people (24.4 ) had a single fall, and 78 (20.2 ) had multiple falls. No significant associations were observed between cognitive function and the risk of single falls. The risk of multiple falls was increased with poorer function in Stroop dot time (RR = 1.03, 95 CI (1.01, 1.05), p = .002) and Stroop word time (RR = 1.02 (1.01, 1.03), p = .001) and reduced with better function in Category Fluency (RR = 0.94 (0.91, 0.98), p = .001) and visuospatial function (RR = 0.95 (0.92, 0.98), p <.001). These associations were amplified by the presence of greater body sway, less ambulatory physical activity, slower reaction time and gait speed, weaker muscle strength, and poorer visual contrast (p for interactions
AB - There is a poor understanding of the interplay between cognitive and physiological functions in leading to falls. We hypothesized that poorer physiological function would modify the effect of poorer cognitive function on increased risk of falling in older people. METHODS: A range of cognitive (executive function/attention, memory, processing speed, and visuospatial ability) and physiological functions (vision, proprioception, sway, leg strength, reaction time) were measured using standardized tests in 386 randomly selected adults aged 60-86. Incident falls were recorded over 12 months. Log-multinomial regression was used to model the relationships and test for interactions between cognition and physiological function in explaining the risk of single or multiple falls. RESULTS: Overall, 94 people (24.4 ) had a single fall, and 78 (20.2 ) had multiple falls. No significant associations were observed between cognitive function and the risk of single falls. The risk of multiple falls was increased with poorer function in Stroop dot time (RR = 1.03, 95 CI (1.01, 1.05), p = .002) and Stroop word time (RR = 1.02 (1.01, 1.03), p = .001) and reduced with better function in Category Fluency (RR = 0.94 (0.91, 0.98), p = .001) and visuospatial function (RR = 0.95 (0.92, 0.98), p <.001). These associations were amplified by the presence of greater body sway, less ambulatory physical activity, slower reaction time and gait speed, weaker muscle strength, and poorer visual contrast (p for interactions
UR - http://biomedgerontology.oxfordjournals.org/content/68/9/1091.full.pdf
U2 - 10.1093/gerona/glt010
DO - 10.1093/gerona/glt010
M3 - Article
SN - 1079-5006
VL - 68
SP - 1091
EP - 1097
JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
IS - 9
ER -