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


CONCLUSIONS
These findings indicate poor performance on physiological fall risk factors, particularly balance, increases the risk of falls in older cognitively impaired people.
Falls and Balance Research Group, Neuroscience Research Australia, Sydney, N.S.W., Australia.
Morag E
ME
Taylor
Stephen R
SR
Lord
Kim
K
Delbaere
A Stefanie
AS
Mikolaizak
Jacqueline C T
JC
Close
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D003072:Cognition Disorders / Q000150:complications* / Q000503:physiopathology; D003704:Dementia / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D004856:Postural Balance / Q000502:physiology*; D011446:Prospective Studies; D011930:Reaction Time / Q000502:physiology*; D012044:Regression Analysis; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors