Beyond balance and mobility, contributions of cognitive function to falls in older adults with cardiovascular disease

Abstract

Objectives: Older adults with cardiovascular disease (CVD) are at risk for cognitive impairment. Cognitive function is associated with falls in older adults however it is unknown if a relationship exists between cognitive function and falls in CVD. The aim of this study was to examine the contributions of cognitive function on falls in older adults with CVD. Methods: A secondary analysis was performed on data from the Health and Retirement Study cohort 2010 (N=3413) of older adults with CVD. Group assignment was based on falls history (yes/no) within the two years prior to the survey. Demographic (age, education, gender, marital status), physical (strength, balance, physical activity, and mobility) and cognitive (immediate and delayed recall, orientation, semantic verbal fluency, numeracy) information was extracted to characterize the sample. Comparisons between groups were completed for all of these variables. Logistic regression was performed to examine associations between each of the cognitive variables and falls while controlling for age, gender, marital status, education, and BMI. Results: Demographic (age, gender, marital status, and education), physical (grip strength, tandem stance time, and gait speed), and cognitive (orientation, immediate and delayed recall) variables differed by falls history (p<0.05). After controlling for confounding, immediate recall was the only significant predictor of falls (OR=1.09, 95% CI=1.01-1.17) (Nagelkerke R 2 =0.037, χ 2 =35.14, p<0.05) with correctly classifying 65.9% of cases. Conclusions: In older adults with CVD, cognitive and physical functions are more impaired in those with a falls history. Screening for cognitive function, specifically immediate recall, should be a part of the management of falls in this population.

Circumstances and Factors Associated With Falls Among Community-Dwelling Older Adults Diagnosed With Heart Disease Using the International Mobility in Aging Study (IMIAS)

“…These differences were in depressive symptoms, physical performance, and FOF, and were consistent with previous studies 36,37. For example, a study demonstrated that fallers with CVD have slower gait speed, more balance impairment, and weaker grip strength than those with no falling history 38. Another found that depression and lower exercise capacity could predict overall functional decline among older adults with coronary heart disease 39.…”

“…36,37 For example, a study demonstrated that fallers with CVD have slower gait speed, more balance impairment, and weaker grip strength than those with no falling history. 38 Another found that depression…”

Executive Functions Are Associated with Fall Risk but not Balance in Chronic Cerebrovascular Disease

“…To our knowledge, little research has investigated the crucial intertwining of EF, measures of physical mobility (balance and fall risk), and cardiovascular disease (potential risk factors for CVD and VCI; [ 17 ]) [ 25 , 26 ] and no study has investigated this relationship in older people with CVD.…”