title: Executive function predicts risk of falls in older adults without balance impairment.
abstract: BACKGROUND
  Executive dysfunction has previously been found to be a risk factor for falls. The aim of this study is to investigate the association between executive dysfunction and risk of falling and to determine if this association is independent of balance.
  
  
  METHODS
  Participants were 188 community-dwelling individuals aged 65 and older. All participants underwent baseline and annual evaluations with review of health history, standardized neurologic examination, neuropsychological testing, and qualitative and quantitative assessment of motor function. Falls were recorded prospectively using weekly online health forms.
  
  
  RESULTS
  During 13 months of follow-up, there were 65 of 188 participants (34.6%) who reported at least one fall. Univariate analysis showed that fallers were more likely to have lower baseline scores in executive function than non-fallers (p = 0.03). Among participants without balance impairment we found that higher executive function z-scores were associated with lower fall counts (p = 0.03) after adjustment for age, sex, health status and prior history of falls using negative binomial regression models. This relationship was not present among participants with poor balance.
  
  
  CONCLUSIONS
  Lower scores on executive function tests are a risk factor for falls in participants with minimal balance impairment. However, this effect is attenuated in individuals with poor balance where physical or more direct motor systems factors may play a greater role in fall risk.
authors: Department of Neurology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, CR-131, Portland, OR 97239 USA. buracchi@ohsu.edu
authors: Teresa J
authors: TJ
authors: Buracchio
authors: Nora C
authors: NC
authors: Mattek
authors: Hiroko H
authors: HH
authors: Dodge
authors: Tamara L
authors: TL
authors: Hayes
authors: Misha
authors: M
authors: Pavel
authors: Diane B
authors: DB
authors: Howieson
authors: Jeffrey A
authors: JA
authors: Kaye
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D056344:Executive Function / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors