title: Cognitive impairment is associated with the absence of fear of falling in community-dwelling frail older adults.
abstract: OBJECTIVE
  The purpose of the present study was to explore the association between cognitive function and fear of falling in frail/non-frail older adults in a community setting.
  
  
  METHODS
  We recruited 483 community-dwelling older adults aged 65 years and older (mean age 73.3 ± 5.1 years, 68.3% women). Fear of falling was assessed using a yes/no question, "Are you afraid of falling?" Cognitive function was measured using the Mini-Mental State Examination. The five subscores of the examination were also recorded. We used the frailty criteria developed by the Cardiovascular Health Study, and divided the participants into non-frail and frail groups according to the number of affected domains. The statistical analyses were carried out separately for these two groups.
  
  
  RESULTS
  A multiple logistic regression analysis showed that, in frail older adults, cognitive impairment was significantly associated with the absence of fear of falling (OR 0.04, 95% CI 0.00-0.50, P = 0.012). In addition, a stepwise multivariate logistic regression analysis showed that the score on the attention and calculation subsection of the Mini-Mental State Examination was positively associated with the presence of fear of falling in frail older adults (OR 1.83, 95% CI 1.08-3.12, P = 0.026). In contrast, cognitive impairment was not associated with fear of falling in non-frail older adults.
  
  
  CONCLUSIONS
  The results suggest that cognitive impairment, especially that in executive function, is associated with the absence of fear of falling in community-dwelling frail older adults. Geriatr Gerontol Int 2017; 17: 232-238.
authors.affiliation: Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Shirooka
authors.affiliation: Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.|Japan Society for the Promotion of Science, Tokyo, Japan.
authors.forename: Shu
authors.initials: S
authors.lastname: Nishiguchi
authors.affiliation: Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Fukutani
authors.affiliation: Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Yuto
authors.initials: Y
authors.lastname: Tashiro
authors.affiliation: Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Yuma
authors.initials: Y
authors.lastname: Nozaki
authors.affiliation: Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Hinako
authors.initials: H
authors.lastname: Hirata
authors.affiliation: Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Moe
authors.initials: M
authors.lastname: Yamaguchi
authors.affiliation: Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Seishiro
authors.initials: S
authors.lastname: Tasaka
authors.affiliation: Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Matsushita
authors.affiliation: Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Matsubara
authors.affiliation: Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Aoyama
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000523:psychology*; D005239:Fear / Q000523:psychology*; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D057187:Independent Living; D016015:Logistic Models; D008297:Male; D009483:Neuropsychological Tests
keywords: accidental falls; cognitive disorders; community; executive function; frail elderly