An 8-year prospective study of the relationship between cognitive performance and falling in very old adults
An 8-year prospective study of the relationship between cognitive performance and falling in very old adults
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DOI：
10.1111/j.1532-5415.2006.00813.x
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发表时间：
2006-08-01
影响因子：
6.3
通讯作者：
Luszcz, Mary A.
中科院分区：
文献类型：
--
作者：
Anstey, Kaarin J.;von Sanden, Chwee;Luszcz, Mary A.
目的：为了确定认知功能是否与认知功能障碍不同，在一个以社区为基础的样本中，在8年的随访中预测跌倒，并评估认知功能的变化与跌倒的关系。设计：前瞻性队列研究，包括1992年、1994年和2000年收集的三波数据。参与者：纳入标准是在基线时完成至少三次认知测试，并在第6波完成福尔斯问卷（N = 539）。在1992年（基线）、1994年和2000年进行了健康和医疗状况、视力、认知功能、功能范围、站立和握力的评估。在这些情况下，获得了过去12个月内福尔斯的自我报告信息。使用广义估计方程的边缘模型用于评估基线认知表现与8年以上跌倒之间的相关性，并对社会人口统计学、健康和感觉运动变量进行调整。随机效应模型被用来评估认知能力的变化和变化之间的关系，在下降率和下降的风险超过8 years.RESULTS：迷你精神状态检查和口头推理在基线预测率下降超过8年的时间。在个体内部，言语能力、处理速度和即时记忆的下降与跌倒率和跌倒风险的增加有关。结论：认知能力与8岁以上的老年人跌倒有关，在临床实践中评估短期和长期跌倒风险时应进行评估。
OBJECTIVES: To determine whether cognitive performance, as distinct from cognitive impairment, predicts falling during an 8-year follow-up in a community-based sample of very old adults and to evaluate how cognitive change is associated with falling.DESIGN: Prospective cohort study including three waves of data collected in 1992, 1994, and 2000.SETTING: Population based, with the baseline sample drawn from the electoral roll.PARTICIPANTS: Inclusion criteria were completion of at least three cognitive tests at baseline and completion of the falls questionnaire at Wave 6 (N = 539).MEASUREMENTS: Assessments of health and medical conditions, visual acuity, cognitive function, functional reach, semitandem stand, and grip strength were conducted in 1992 (baseline), 1994, and 2000. Self-report information on falls in the previous 12 months was obtained on each of these occasions. Marginal models using generalized estimating equations were used to assess the association between baseline cognitive performance and falling over 8 years, adjusting for sociodemographic, health, and sensorimotor variables. Random effects models were used to assess the relationship between change in cognitive performance and change in fall rate and fall risk over 8 years.RESULTS: Mini-Mental State Examination and verbal reasoning at baseline predicted rate of falling over an 8-year period. Within individuals, declines in verbal ability, processing speed, and immediate memory were associated with increases in rates of falling and fall risk.CONCLUSION: Cognitive performance is associated with falling over 8 years in very old adults and should be assessed in clinical practice when evaluating short- and long-term fall risk.