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Cognitive and physical declines and falls in older people with and without mild cognitive impairment: a 7-year longitudinal study

Published online by Cambridge University Press:  20 April 2023

Thanwarat Chantanachai Open the ORCID record for Thanwarat Chantanachai [Opens in a new window] ,
Daina L. Sturnieks Open the ORCID record for Daina L. Sturnieks [Opens in a new window] ,
Stephen R. Lord Open the ORCID record for Stephen R. Lord [Opens in a new window] ,
Jasmine Menant Open the ORCID record for Jasmine Menant [Opens in a new window] ,
Kim Delbaere Open the ORCID record for Kim Delbaere [Opens in a new window] ,
Perminder S. Sachdev Open the ORCID record for Perminder S. Sachdev [Opens in a new window] ,
Henry Brodaty Open the ORCID record for Henry Brodaty [Opens in a new window] ,
Peter Humburg Open the ORCID record for Peter Humburg [Opens in a new window]  and
Morag E. Taylor Open the ORCID record for Morag E. Taylor [Opens in a new window]
Thanwarat Chantanachai
Affiliation:
Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
Daina L. Sturnieks
Affiliation:
Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
Stephen R. Lord
Affiliation:
Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
Jasmine Menant
Affiliation:
Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
Kim Delbaere
Affiliation:
Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
Perminder S. Sachdev
Affiliation:
Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia
Henry Brodaty
Affiliation:
Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
Peter Humburg
Affiliation:
Stats Central, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW, Australia
Morag E. Taylor*
Affiliation:
Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
*
Correspondence should be addressed to: Morag E. Taylor, Falls, Balance and Injury Research Centre, Neuroscience Research Australia, PO Box 1165, Randwick, NSW 2031, Australia. Phone: +61293991885. Email: m.taylor@neura.edu.au
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Abstract

Objectives:

We examined longitudinal changes in cognitive and physical function and associations between change in function and falls in people with and without mild cognitive impairment (MCI).

Design:

Prospective cohort study with assessments every 2 years (for up to 6 years).

Setting:

Community, Sydney, Australia.

Participants:

Four hundred and eighty one people were classified into three groups: those with MCI at baseline and MCI or dementia at follow-up assessments (n = 92); those who fluctuated between cognitively normal and MCI throughout follow-up (cognitively fluctuating) (n = 157), and those who were cognitively normal at baseline and all reassessments (n = 232).

Measurements:

Cognitive and physical function measured over 2–6 years follow-up. Falls in the year following participants’ final assessment.

Results:

In summary, 27.4%, 38.5%, and 34.1% of participants completed 2, 4, and 6 years follow-up of cognitive and physical performance, respectively. The MCI and cognitive fluctuating groups demonstrated cognitive decline, whereas the cognitively normal group did not. The MCI group had worse physical function than the cognitively normal group at baseline but decline over time in physical performance was similar across all groups. Decline in global cognitive function and sensorimotor performance were associated with multiple falls in the cognitively normal group and decline in mobility (timed-up-and-go test) was associated with multiple falls across the whole sample.

Conclusions:

Cognitive declines were not associated with falls in people with MCI and fluctuating cognition. Declines in physical function were similar between groups and decline in mobility was associated with falls in the whole sample. As exercise has multiple health benefits including maintaining physical function, it should be recommended for all older people. Programs aimed at mitigating cognitive decline should be encouraged in people with MCI.

Keywords

agingfallscognitive disorderslongitudinal studies
Type
Original Research Article
Information
International Psychogeriatrics , Volume 36 , Special Issue 4: Issue Theme: Behavioral and Physical Impairments in Persons with Cognitive Disorders , April 2024 , pp. 306 - 316
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of International Psychogeriatric Association

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