Executive function predicts risk of falls in older adults without balance impairment
Executive function predicts risk of falls in older adults without balance impairment
复制标题
DOI：
10.1186/1471-2318-11-74
复制
发表时间：
2011-01-01
期刊：
影响因子：
4.1
通讯作者：
Kaye, Jeffrey A.
中科院分区：
文献类型：
--
作者：
Buracchio, Teresa J.;Mattek, Nora C.;Kaye, Jeffrey A.
背景：先前发现执行功能障碍是跌倒的危险因素。本研究的目的是调查执行功能障碍与跌倒风险之间的关系，并确定这种关系是否独立于平衡。方法：参与者为188名65岁及以上的社区居民。所有参与者都接受了基线和年度评估，包括健康史回顾、标准化神经系统检查、神经心理测试以及运动功能的定性和定量评估。使用每周在线健康表格前瞻性地记录跌倒情况。结果：在13个月的随访中，188名参与者中有65人（34.6%）报告至少有一次跌倒。单变量分析显示，跌倒者比非跌倒者在执行功能方面的基线得分更低（p = 0.03）。在没有平衡障碍的参与者中，我们发现在使用负二项回归模型调整年龄、性别、健康状况和既往跌倒史后，执行功能z分数越高，跌倒次数越少（p = 0.03）。这种关系在平衡能力差的参与者中不存在。结论：执行功能测试得分较低是轻度平衡障碍参与者跌倒的危险因素。然而，这种影响在平衡能力差的个体中减弱，身体或更直接的运动系统因素可能在跌倒风险中发挥更大的作用。
Background: Executive dysfunction has previously been found to be a risk factor for falls. The aim of this study is to investigate the association between executive dysfunction and risk of falling and to determine if this association is independent of balance.Methods: Participants were 188 community-dwelling individuals aged 65 and older. All participants underwent baseline and annual evaluations with review of health history, standardized neurologic examination, neuropsychological testing, and qualitative and quantitative assessment of motor function. Falls were recorded prospectively using weekly online health forms.Results: During 13 months of follow-up, there were 65 of 188 participants (34.6%) who reported at least one fall. Univariate analysis showed that fallers were more likely to have lower baseline scores in executive function than non-fallers (p = 0.03). Among participants without balance impairment we found that higher executive function z-scores were associated with lower fall counts (p = 0.03) after adjustment for age, sex, health status and prior history of falls using negative binomial regression models. This relationship was not present among participants with poor balance.Conclusions: Lower scores on executive function tests are a risk factor for falls in participants with minimal balance impairment. However, this effect is attenuated in individuals with poor balance where physical or more direct motor systems factors may play a greater role in fall risk.