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

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.