Easily Identifiable Risk Factors Can Help Target People with MCI at Risk for Falls
FOR IMMEDIATE RELEASE: July 20, 2023
Contact: Ellen Mullally
Identifying fall risk factors can improve outcomes in older adults, but there has been little study on what these might be for those with mild cognitive impairment (MCI). However, a new study in the July issue of JAMDA suggests some easily attainable risk factors that can help identify those individuals with MCI who might have a higher risk of falls.
In What Factors Can Be Used to Identify Older Patients with MCI at Risk of Falling? Findings from the MEMENTO Cohort, the authors used data from a large, French, prospective cohort of older adults. They found that fallers with MCI performed lower in executive function, balance, and gait tests. At the same time, age, gender, the number of limitations in instrumental activities of living, and living alone were significantly associated with falls. These were all simple to identify and target, they noted.
The researchers didn’t observe statistical differences in a multivariable analysis of neuropsychological or objective physical measures, although in a subgroup of people aged 75 or over, the presence of executive disorders was significantly associated with the occurrence of at least one fall after adjusting for demographic variables.
The researchers noted that the fallers in this study were shorter than non-fallers. This might reflect osteoporosis and/or other postural changes, they suggested.
The authors concluded, “The association between cognitive impairment and the risk of falls varies with the severity of cognitive impairment. The fall risk factors in patients living with dementia appear to be similar to those observed in healthy counterparts, i.e., previous falls, depression, and symptomatic orthostatic hypotension.” However, in people with MCI, studies have revealed that lower muscle strength, living alone, and depression are risk factors for falling. Their study, they said, is interesting in that it identified independent activities of daily living limitations and not physical measures associated with falling.
As a result of their findings, the authors suggested sociodemographic factors and executive function disorders for those individuals aged 75 or older could be used to target older patients with MCI who are at risk for falls. However, they noted, “Our level of knowledge of falls risk factors is still insufficient, which prevents the definition of targets for single-factor or multifactorial fall prevention interventions in people with MCI.” Future studies, they said, could help by comparing risk factors for falls in older patients with MCI to those with dementia.
This study was conducted by researchers at the Division of Geriatric Medicine, Tours University Hospital, Tours, France; Education, Ethics, Health, University of Medicine of Tours, Tours, France; Memory Clinic, Tours University Hospital, Tours, France; Department of Gerontology, Lille University Hospital, Lille, France; University Lille, Fille, France; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland; University of Bordeaux, Bordeaux, France; CHU Bordeaux, Bordeaux, France; and Memory Clinic, Licend, Lille, France.
JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine. JAMDA publishes peer-reviewed articles, including original studies, reviews, clinical experience articles, case reports, and more, on all topics more important to post-acute and long-term care medicine. Visit www.jamda.com for more information.
About AMDA – The Society for Post-Acute and Long-Term Care Medicine
AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit www.paltc.org for more information.