Cognitive performances better identify fallers than mobility assessment among older adults with fear of falling

Abstract

Background: Half of the people with fear of falling (FoF) are non-fallers, and the reason why some people considered non-fallers are afraid of falling is unknown, but reduced mobility or cognition, or both concurrently must be considered as potential risk factors.

Aim: The study aimed to determine if mobility and/or cognitive abilities could identify people with a history of falls in older adults with FoF.

Methods: Twenty-six older adults with FoF participated in this study. Full cognitive and mobility assessments were performed assessing global cognitive impairments (MoCA score < 26), executive functions, memory, processing speed, visuospatial skills, mobility impairment (TUG time > 13.5 s), gait, balance and physical capacity. Information about falls occurring during the year prior to the inclusion was collected. Logistic regression analyses were performed to explore the association between falls and cognitive and mobility abilities.

Results: No significant differences in age, sex, level of education or body mass index were detected between fallers and non-fallers. Cognitive impairments (MoCA score < 26) distinguished between fallers and non-fallers (p = 0.038; R² = 0.247). Among specific cognitive functions, visuospatial skills distinguished between fallers and non-fallers (p = 0.027; R² = 0.258). Mobility impairments (TUG time > 13.5 s), gait, balance and physical capacity were not related to past falls.

Discussion/conclusion: In older adults with FoF, global cognitive deficits detected by the MoCA are important factors related to falls and more particularly visuospatial skills seem to be among the most implicated functions. These functions could be targeted in multifactorial interventions.

Keywords: Aged 65 and over; Balance; Composite scores; Gait; Visuospatial skills.