Rebecca S Crow1,2, Christian Haudenschild2,3, Matthew C Lohman4, Robert M Roth2,5, Meredith Roderka6, Travis Masterson7, John Brand2, Tyler Gooding6, Todd A Mackenzie2,6,3, John A Batsis8,9. 1. Veterans Affairs Medical Center, White River Junction, White River Junction, Vermont, USA. 2. Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA. 3. The Dartmouth Institute for Health Policy, Lebanon, New Hampshire, USA. 4. Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA. 5. Department of Psychiatry, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA. 6. Department of Medicine, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA. 7. Department of Nutritional Sciences, The Pennsylvania State University, State College, Pennsylvania, USA. 8. Division of Geriatric Medicine, School of Medicine, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. 9. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Abstract
BACKGROUND/ OBJECTIVES: It is unknown whether older adults at high risk of falls but without cognitive impairment have higher rates of subsequent cognitive impairment. DESIGN: This was an analysis of cross-sectional and longitudinal data from National Health and Aging Trends Study (NHATS). SETTING: NHATS, secondary analysis of data from 2011 to 2019. PARTICIPANTS: Community dwelling adults aged 65 and older without cognitive impairment. MEASUREMENTS: Participants were classified at baseline in three categories of fall risk (low, moderate, severe) using a modified algorithm from the Center for Disease Control's STEADI (Stop Elderly Accidents, Deaths, and Injuries) and fall risk from data from the longitudinal NHATS. Impaired global cognition was defined as NHATS-derived impairment in either the Alzheimer's Disease-8 score, immediate/delayed recall, orientation, clock-drawing test, or date/person recall. The primary outcome was the first incident of cognitive impairment in an 8 year follow-up period. Cox-proportional hazard models ascertained time to onset of cognitive impairment (referent = low modified STEADI incidence). RESULTS: Of the 7,146 participants (57.8% female), the median age category was 75 to 80 years. Prevalence of baseline fall modified STEADI risk categories in participants was low (51.6%), medium (38.5%), and high (9.9%). In our fully adjusted model, the risk of developing cognitive impairment was hazard ratio (HR) 1.18 [95% CI = 1.08, 1.29] in the moderate risk category, and HR 1.74 [95% CI = 1.53, 1.98] in the high-risk category. CONCLUSION: Older, cognitively intact adults at high fall risk at baseline had nearly twice the risk of cognitive decline at 8 year follow-up.
BACKGROUND/ OBJECTIVES: It is unknown whether older adults at high risk of falls but without cognitive impairment have higher rates of subsequent cognitive impairment. DESIGN: This was an analysis of cross-sectional and longitudinal data from National Health and Aging Trends Study (NHATS). SETTING: NHATS, secondary analysis of data from 2011 to 2019. PARTICIPANTS: Community dwelling adults aged 65 and older without cognitive impairment. MEASUREMENTS: Participants were classified at baseline in three categories of fall risk (low, moderate, severe) using a modified algorithm from the Center for Disease Control's STEADI (Stop Elderly Accidents, Deaths, and Injuries) and fall risk from data from the longitudinal NHATS. Impaired global cognition was defined as NHATS-derived impairment in either the Alzheimer's Disease-8 score, immediate/delayed recall, orientation, clock-drawing test, or date/person recall. The primary outcome was the first incident of cognitive impairment in an 8 year follow-up period. Cox-proportional hazard models ascertained time to onset of cognitive impairment (referent = low modified STEADI incidence). RESULTS: Of the 7,146 participants (57.8% female), the median age category was 75 to 80 years. Prevalence of baseline fall modified STEADI risk categories in participants was low (51.6%), medium (38.5%), and high (9.9%). In our fully adjusted model, the risk of developing cognitive impairment was hazard ratio (HR) 1.18 [95% CI = 1.08, 1.29] in the moderate risk category, and HR 1.74 [95% CI = 1.53, 1.98] in the high-risk category. CONCLUSION: Older, cognitively intact adults at high fall risk at baseline had nearly twice the risk of cognitive decline at 8 year follow-up.
Authors: Melissa A Russell; Keith D Hill; Irene Blackberry; Lesley L Day; Shyamali C Dharmage Journal: J Gerontol A Biol Sci Med Sci Date: 2006-10 Impact factor: 6.053
Authors: Matthew C Lohman; Rebecca S Crow; Peter R DiMilia; Emily J Nicklett; Martha L Bruce; John A Batsis Journal: J Epidemiol Community Health Date: 2017-09-25 Impact factor: 3.710
Authors: Girish Valluru; Jean Yudin; Christine L Patterson; Joanna Kubisiak; Peter Boling; George Taler; Karl Eric De Jonge; Steve Touzell; Ann Danish; Katherine Ornstein; Bruce Kinosian Journal: J Am Geriatr Soc Date: 2019-05-10 Impact factor: 5.562