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. 2022 Jul 5:9:900488.
doi: 10.3389/fmed.2022.900488. eCollection 2022.

The Value of Cognitive and Physical Function Tests in Predicting Falls in Older Adults: A Prospective Study

Rong Zhou  1 , Jiayu Li  1 , Meiling Chen  2
Affiliations

The Value of Cognitive and Physical Function Tests in Predicting Falls in Older Adults: A Prospective Study

Rong Zhou et al. Front Med (Lausanne). .

Abstract

Introduction: Previous studies suggested that physical and cognitive function can be indicators to assess the risk of falls in the elderly. Various tests are widely used in geriatric clinical studies as assessment tools of physical and cognitive function. However, large sample studies comparing the fall predictive value of these tests are still sparse. This study was conducted to investigate the value of cognitive and physical function tests in predicting the risk of subsequent falls in the elderly, with the overarching goal of providing more evidence on fall-risk assessment.

Methods: The current study was based on the data of respondents aged 60 and above from the China Health and Retirement Longitudinal Study (CHARLS). Data from the 2015 CHARLS national survey were used as the baseline data, and the fall data in 2018 were used as the follow-up data. Physical function tests included balance, walking speed, the five times sit-to-stand test (FTSST), and grip strength. The value of cognitive and physical function tests in predicting falls was evaluated by logistic regression analysis and receiver operating characteristic (ROC) curves.

Results: The incidence of falls among the 4,857 subjects included in this study was 20.86%. Results showed that cognition (OR = 0.83, 95% CI: 0.70-0.98), the FTSST (OR = 3.51, 95% CI: 1.66-7.46), and grip strength (OR = 1.02, 95% CI: 1.01-1.03) were independent predictors of falls in the full sample after adjusting for various confounders. Notably, the above tests showed better predictive value for falls for the oldest-old (≥ 80 years) subjects.

Conclusion: Overall, results showed that grip strength, the FTSST, and cognition tests are simple and practicable tools for identifying individuals at higher risk of falls in the community. Moreover, the fall predictive performance of physical and cognitive function tests was age-dependent, with a higher predictive value in older adults aged 80 and above.

Keywords: balance; cognition; fall risk assessment; grip strength; older adults; the five times sit-to-stand test; walking speed.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow-chart showing the process of enrolling participants in the analysis.
FIGURE 2
FIGURE 2
ROC curves of the five tests in the full sample (n = 4,857).
FIGURE 3
FIGURE 3
ROC curves of the five tests in older adults ≥ 80 years (n = 166).
See this image and copyright information in PMC

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