Lien T Quach1, Rachel E Ward2, Mette M Pedersen3, Suzanne G Leveille4, Laura Grande5, David R Gagnon6, Jonathan F Bean7. 1. New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA; Massachusetts Veterans Epidemiology and Research Information Center, VA Boston Healthcare System, Boston, MA; Department of Gerontology, University of Massachusetts Boston, Boston, MA. Electronic address: Lien.Quach@va.gov. 2. Massachusetts Veterans Epidemiology and Research Information Center, VA Boston Healthcare System, Boston, MA; Spaulding Rehabilitation Hospital, Boston, MA; Harvard Medical School, Cambridge, MA. 3. Clinical Research Centre, Copenhagen University Hospital Hvidovre, Denmark. 4. College of Nursing and Health Sciences, University of Massachusetts Boston, Boston, MA; Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Cambridge, MA. 5. Beth Israel Deaconess Medical Center, Boston, MA; VA Boston Healthcare System, Boston, MA. 6. Massachusetts Veterans Epidemiology and Research Information Center, VA Boston Healthcare System, Boston, MA; Department of Biostatistics, Boston University, Boston, MA. 7. New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA; Spaulding Rehabilitation Hospital, Boston, MA; Harvard Medical School, Cambridge, MA.
Abstract
OBJECTIVES: To examine associations between mild cognitive impairment (MCI) and falls among primary care patients, and to investigate whether social engagement (SE) modifies these associations. DESIGN: Cross sectional analysis using baseline data from an observational cohort study. SETTING: Primary care. PARTICIPANTS: Community-dwelling older adults (N=430) at risk of mobility decline with a mean age of 76.6 years (range 65-96y). MAIN OUTCOME MEASURES: The number of falls in the past year was reported at the baseline interview. MCI was identified using a cutoff of 1.5 SD below the age-adjusted mean on at least 2 of the standardized cognitive performance tests. SE (eg, keeping in touch with friends and family, volunteering, participating social activities…) was assessed with the Late Life Function and Disability Instrument, and required a score above the median value 49.5 out of 100. RESULTS: MCI was present among 42% of participants and 42% reported at least 1 fall in the preceding year. Using generalized estimating equations, MCI was associated with a 77% greater rate of falls (P<.05). There was a statistically significant interaction between SE and MCI on the rate of falls (P<.01), such that at a high level of SE, MCI was not statistically associated with falls (P=.83). In participants with lower levels of SE, MCI is associated with 1.3 times greater rate of falls (P<.01). CONCLUSIONS: While MCI is associated with a greater risk for falls, higher levels of SE may play a protective role.
OBJECTIVES: To examine associations between mild cognitive impairment (MCI) and falls among primary care patients, and to investigate whether social engagement (SE) modifies these associations. DESIGN: Cross sectional analysis using baseline data from an observational cohort study. SETTING: Primary care. PARTICIPANTS: Community-dwelling older adults (N=430) at risk of mobility decline with a mean age of 76.6 years (range 65-96y). MAIN OUTCOME MEASURES: The number of falls in the past year was reported at the baseline interview. MCI was identified using a cutoff of 1.5 SD below the age-adjusted mean on at least 2 of the standardized cognitive performance tests. SE (eg, keeping in touch with friends and family, volunteering, participating social activities…) was assessed with the Late Life Function and Disability Instrument, and required a score above the median value 49.5 out of 100. RESULTS: MCI was present among 42% of participants and 42% reported at least 1 fall in the preceding year. Using generalized estimating equations, MCI was associated with a 77% greater rate of falls (P<.05). There was a statistically significant interaction between SE and MCI on the rate of falls (P<.01), such that at a high level of SE, MCI was not statistically associated with falls (P=.83). In participants with lower levels of SE, MCI is associated with 1.3 times greater rate of falls (P<.01). CONCLUSIONS: While MCI is associated with a greater risk for falls, higher levels of SE may play a protective role.
Authors: J M Guralnik; L Ferrucci; C F Pieper; S G Leveille; K S Markides; G V Ostir; S Studenski; L F Berkman; R B Wallace Journal: J Gerontol A Biol Sci Med Sci Date: 2000-04 Impact factor: 6.053
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Authors: Amy J Jak; Mark W Bondi; Lisa Delano-Wood; Christina Wierenga; Jody Corey-Bloom; David P Salmon; Dean C Delis Journal: Am J Geriatr Psychiatry Date: 2009-05 Impact factor: 4.105