Increased risk of falling in older community-dwelling women with mild cognitive impairment

Teresa Y Liu-Ambrose, Maureen C Ashe, Peter Graf, B Lynn Beattie, Karim M Khan
Physical Therapy 2008, 88 (12): 1482-91

BACKGROUND: Falls are a major health care problem for older people and are associated with cognitive dysfunction. Mild cognitive impairment (MCI) is an increasingly recognized clinical problem. No study has comprehensively compared people with and without MCI for fall risk factors in both the physiological and cognitive domains.

OBJECTIVE: The purpose of this cross-sectional study was to comprehensively compare fall risk factors in community-dwelling older women with and without MCI.

DESIGN: A cross-sectional design was used in the study.

METHODS: Community-dwelling women (N=158) with Folstein Mini Mental State Examination scores of >or=24 participated in the study. The Montreal Cognitive Assessment (MoCA) was used to categorize participants as either having or not having MCI. Each participant's fall risk profile was assessed with the Physiological Profile Assessment (PPA). Three central executive functions were assessed: (1) set shifting was assessed with the Trail Making Test (part B), (2) updating (ie, working memory) was assessed with the Verbal Digits Backward Test, and (3) response inhibition was assessed with the Stroop Colour-Word Test.

RESULTS: Both the composite PPA score and its subcomponent, postural sway performance, were significantly different between the 2 groups; participants with MCI had higher composite PPA scores and greater postural sway compared with participants without MCI. Participants with MCI performed significantly worse on all 3 central executive function tests compared with participants without MCI.

LIMITATIONS: A screening tool was used to categorize participants as having MCI, and fall risk factors were compared rather than the actual incidence of falls.

CONCLUSIONS: Fall risk screening may be prudent in older adults with MCI.

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