Cognitive function and falling among older adults with mild cognitive impairment and slow gait

Abstract

Aim: To examine the association of the combination of slow gait and mild cognitive impairment (MCI) with cognitive function and falling in community-dwelling older people.

Methods: Participants were selected from the Obu Study of Health Promotion for the Elderly (n = 3400), and underwent gait examination and a battery of neuropsychological examinations, including the Mini-Mental State Examination and the National Center for Geriatrics and Gerontology Functional Assessment Tool (tablet version of Trail Making Test Part A and B, Symbol Digit Substitution Task, Figure selection task, Word memory and Story memory), and were interviewed with a series of questionnaires including medical history, physical activity, geriatric depression scale and fall history.

Results: Participants were classified into control (n = 2281), slow gait speed (SG; n = 278), MCI (n = 673) and MCI with SG (MCI+SG; n = 168) groups. All cognitive functions were significantly affected by the group factor, even adjusting for participant characteristics as covariates (P < 0.001). Post-hoc analysis showed that the control group had better performance than the other groups, and the MCI+SG group had worse performance than the other groups in all cognitive functions (all P < 0.05). In multiple logistic regression analysis, SG and MCI were independently associated with falling (all P < 0.05), and MCI+SG had a higher odds ratio for falling (adjusted OR 1.99, 95% CI 1.08-3.65).

Conclusions: Our findings support the idea that slow gait and MCI were related, and concurrently associated with falling. Motor function among MCI subjects should be focused on to assess profile risks.

Keywords: cognition; elderly; gait; mild cognitive impairment; neuropsychological assessment.