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Physical impairments in cognitively impaired older people: implications for risk of falls

Published online by Cambridge University Press:  26 July 2012

Morag E. Taylor*
Affiliation:
Falls and Balance Research Group, Neuroscience Research Australia, University of New South Wales, Sydney, Australia Prince of Wales Clinical School, University of New South Wales, Sydney, Australia
Kim Delbaere
Affiliation:
Falls and Balance Research Group, Neuroscience Research Australia, University of New South Wales, Sydney, Australia
Stephen R. Lord
Affiliation:
Falls and Balance Research Group, Neuroscience Research Australia, University of New South Wales, Sydney, Australia
A. Stefanie Mikolaizak
Affiliation:
Falls and Balance Research Group, Neuroscience Research Australia, University of New South Wales, Sydney, Australia
Jacqueline C. T. Close*
Affiliation:
Prince of Wales Clinical School, University of New South Wales, Sydney, Australia Falls and Injury Prevention Group, Neuroscience Research Australia, University of New South Wales, Sydney, Australia
*
Morag Taylor, Neuroscience Research Australia, Barker Street, Randwick, NSW, 2031, Australia. Tel: +61293991060, Fax: +61293991204, E-mail: m.taylor@neura.edu.au.
Correspondence should be addressed to: Jacqueline Close, Neuroscience Research Australia, Barker Street, Randwick, NSW, 2031, Australia. Tel: +61293991055; Fax: +61293991204. E-mail: j.close@neura.edu.au

Abstract

Background: Cognitively impaired older people fall twice as often as their cognitively intact counterparts. There is, however, limited information on factors that increase the risk of falls in this population. This study aimed to determine whether a group of cognitively impaired older people (CIG) perform worse than a matched group of cognitively intact older people (NCIG) on a profile of physical performance and mobility tests.

Methods: One hundred and thirty-eight cognitively impaired and 276 age and gender matched cognitively intact community-dwelling older adults (>60 years) took part in the study. Participants completed a detailed physical performance battery from which composite fall risk scores were derived. Falls were measured prospectively for 12 months with monthly falls diaries, telephone calls, and by regularly contacting participants’ “person responsible.”

Results: The CIG performed worse than the NCIG in tests of reaction time, muscle strength (grip and quadriceps), balance (sway on floor, sway on foam, controlled leaning balance and near tandem standing ability), and mobility (sit to stand, timed up and go (TUG) and steps required to turn 180 degrees). The CIG had significantly higher composite fall risk scores than the NCIG and fell significantly more during follow-up (Multiple falls (2+): CIG 43%; NCIG 21%).

Conclusions: Fall risk in the CIG was significantly increased due to multiple physical impairments. Physical profiles provide a means of quantifying the extent of impairment in older people with cognitive impairment and potential direction for targeting interventions for reducing fall risk.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2012

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