Is Fear of Falling Associated With Decline in Global Cognitive Functioning in Older Adults: Findings From the Irish Longitudinal Study on Ageing
Journal of the American Medical Directors Association
J Am Med Dir Assoc. 2018 Mar;19(3):248-254.e3. doi: 10.1016/j.jamda.2017.09.012. Epub 2017 Nov 3.
ABSTRACT
BACKGROUND: Fear of falling (FoF) is present in 20% to 85% of older adults and may be an early marker of decline in global cognitive functioning (GCF). We tested the hypothesis that FoF is associated with lower levels of GCF (cross-sectional) and greater decline in GCF (prospective) in adults aged 50 and older.
DESIGN: Observational cohort study.
SETTING: The Irish Longitudinal Study on Ageing, a population-based study.
PARTICIPANTS: Data were from 4931 participants (mean age 62.9 ± 9.1, range 50-98, 54.3% female).
MEASUREMENTS: FoF was based on self-report in 2010. GCF was measured with the Montreal Cognitive Assessment (MoCA) and Mini Mental Status Examination (MMSE) in 2010 and 2014. The cross-sectional association was examined using linear regression unadjusted and after adjustment for demographic and health factors. The prospective association between FoF and the odds of >1-SD decline in GCF were examined using logistic regression. Interaction with age and mediation by social and physical activities were examined.
RESULTS: In 2010, 21.9% of participants reported FoF. In the unadjusted cross-sectional models, those with FoF had lower scores on the MoCA (B -1.15, 95% confidence interval [CI] -1.40 to -0.90) and MMSE (B -0.52, CI -0.67 to -0.37). In the unadjusted prospective models, FoF was associated with a greater odds of decline in MoCA (odds ratio [OR] 1.60, CI 1.26-2.04) and MMSE (OR 1.64, CI 1.29-2.08). After adjustment for covariates, all associations attenuated and were no longer statistically significant, except the association with decline in MoCA (OR 1.32, CI 1.01-1.71). No statistically significant interaction with age was found (P > .37). Additional adjustment for social and physical activity did not change the results.
CONCLUSIONS: The findings provide weak evidence for FoF as a predictor of cognitive decline.
