4.6 Article

Risk factors for falls in community-dwelling older people with mild cognitive impairment: a prospective one-year study

Journal

PEERJ
Volume 10, Issue -, Pages -

Publisher

PEERJ INC
DOI: 10.7717/peerj.13484

Keywords

Accidental falls; Aged; Cognitive dysfunction; Postural balance; Psychotropic drugs; Vision disorders

Funding

  1. National Health & Medical Research Council (NHMRC) [ID350833, ID568969, APP1093083]
  2. NHMRC Centre for Research Excellence in the Prevention of Fall-related Injuries
  3. NHMRC Investigator grant

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This study found that there are several risk factors for falls in older people with MCI, including poor visual contrast sensitivity, impaired balance, and the use of psychotropic medication. These risk factors can be addressed and considered in fall prevention programs.
Objective: Mild cognitive impairment (MCI) is considered an intermediate stage between normal cognitive function and dementia. Fall risk is increased in this group, but there is limited literature exploring specific fall risk factors that may be addressed in fall prevention strategies. The aim of this study was to examine risk factors for falls in older people with MCI, focusing on cognitive, psychological and physical factors. Methods: Participants (n = 266, 45% women) were community-dwelling older people aged 70???90 years who met the criteria for MCI. Cognitive, psychological, sensorimotor and physical assessments, physical activity levels, medication use, general health and disability were ascertained at baseline. Falls were monitored prospectively for 12 months. Results: During follow-up, 106 (40%) participants reported one or more falls. Poorer visual contrast sensitivity, increased postural sway, lower levels of weekly walking activity, higher levels of depressive symptoms and psychotropic medication use were significantly associated with faller status (???1 falls) in univariable analyses. Of these factors, poor visual contrast sensitivity, increased postural sway and psychotropic medication use were found to be significant independent predictors of falls in multivariable analysis while controlling for age and sex. No measures of cognitive function were associated with falls. Conclusions: Poor visual contrast sensitivity, impaired balance and psychotropic medication use predicted falls in community-dwelling people with MCI. These risk factors may be amenable to intervention, so these factors could be carefully considered in fall prevention programs for this population.

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