Screening for Cognitive Impairment as a Part of Falls Risk Assessment in Physical Therapist Practice

Background and Purpose: Older adults with impaired cognition are more than twice as likely to fall as their age-matched cognitively intact peers. Physical therapists play a key role in falls screening and prevention efforts; however, it is unknown how often or in what capacity cognitive screenings are performed within falls risk assessments. The purpose of this study was to describe the cognitive screening practice patterns of physical therapists (PTs) as a part of falls risk assessments. Subjects: An electronic survey was sent to a random selection of 500 licensed PTs from 1 state. Methods: Factors associated with cognitive screening practices and respondents' demographic information were gathered. Group comparisons between those who screened and did not screen cognition were completed. Results: Our response rate was 42.8% (n = 214). Only 32.7% (n = 70) of respondents reported screening cognition as a part of falls risk assessments. When performed, orientation was most commonly screened (80.0%, n = 56) followed by a dementia screen using the Mini-Mental State Examination (64.3%, n = 45). Significant differences between groups on cognitive screening practices were found on the basis of work setting, practice time spent with older adults, and practice time spent examining falls risk. Discussion: Screening for mild deficits in cognitive function is limited within physical therapy practice, which likely influences the detection of early cognitive declines associated with functional limitations. Conclusions: Considering the number of older adults at risk for falling and the likelihood of undiagnosed cognitive impairment, PTs should screen for cognitive deficits as a part of falls risk assessments.