TY  - JOUR
PY  - 2023//
TI  - The direct and mediating effects of cognitive impairment on the occurrence of falls: a cohort study based on community-dwelling old adults
JO  - Frontiers in medicine
A1  - Zhang, Tianyi
A1  - Yang, Cunmei
A1  - Shu, Gangming
A1  - Gao, Chang
A1  - Ma, Hongying
A1  - Zou, Lin
A1  - Zuo, Jing
A1  - Liu, Shaoni
A1  - Yan, Jin
A1  - Hu, Yixin
SP  - e1190831
EP  - e1190831
VL  - 10
IS  - 
N2  - BACKGROUND: Cognitive impairment has been reported to be associated with falls in older adults. However, the complex relationship among falls, cognitive impairment and its associated factors, which could be targeted with specific interventions, remains to be elucidated. This study aimed to examine the direct effects of cognitive impairment on falls, to identify the factors associated with cognitive impairment and to explore the mediation role of cognitive impairment in the association of fall with cognition related factors. <br><br>METHODS: This 1-year follow-up cohort study enrolled old adults aged 60  years or over. Information about demographic and anthropometric characteristics, fall outcomes, function and nutritional status were collected through face-to-face interview. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA). Multivariable regression analyses were used to test the association between cognitive impairment and falls and to identify the factors related to cognitive impairment. Additionally, we conduct causal mediation analyses to estimate the mediation effects of cognitive impairment in the pathways of fall occurrence. <br><br>RESULTS: Of the 569 participants included in this study, 366 (64.32%) had cognitive impairment, 96 (16.87%) had fall history in the past 1  year, 81 (14.24%) experienced fall and 47 (8.26%) received treatment because of falling during the 1-year follow-up. The association between cognitive impairment and 1-year fall risk was confirmed after adjusting for multiple covariates [odds ratio (OR):2.03, 95% confidence interval (CI): 1.13-3.80]. IADL disability, depression and low grip strength were associated with a higher prevalence of cognitive impairment. While overweight, higher education and higher income level were found to be related to a lower risk of cognitive impairment. Among these associated factors, cognitive impairment mediated the positive association of falling with IADL ability and depression, and a negative relationship with education and income level. <br><br>CONCLUSION: Our study not only confirmed the direct influence of cognitive impairment on fall risk in older adults, but also suggested a mediating role that cognitive impairment played in the pathways of fall occurrence. Our finding could help develop more specific interventions for fall prevention.<p />  <p>Language: en</p>
LA  - en
SN  - 2296-858X
UR  - http://dx.doi.org/10.3389/fmed.2023.1190831
ID  - ref1
ER  -