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Executive function and falls in older adults: New findings from a five-year prospective study link fall risk to cognition

Recent findings suggest that executive function (EF) plays a critical role in the regulation of gait in older adults, especially under complex and challenging conditions, and that EF deficits may, therefore, contribute to fall risk. The objective of this study was to evaluate if reduced EF is a risk...

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Published in:PloS one 2012-06, Vol.7 (6), p.e40297-e40297
Main Authors: Mirelman, Anat, Herman, Talia, Brozgol, Marina, Dorfman, Moran, Sprecher, Elliot, Schweiger, Avraham, Giladi, Nir, Hausdorff, Jeffrey M
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description Recent findings suggest that executive function (EF) plays a critical role in the regulation of gait in older adults, especially under complex and challenging conditions, and that EF deficits may, therefore, contribute to fall risk. The objective of this study was to evaluate if reduced EF is a risk factor for future falls over the course of 5 years of follow-up. Secondary objectives were to assess whether single and dual task walking abilities, an alternative window into EF, were associated with fall risk. We longitudinally followed 256 community-living older adults (age: 76.4±4.5 yrs; 61% women) who were dementia free and had good mobility upon entrance into the study. At baseline, a computerized cognitive battery generated an index of EF, attention, a closely related construct, and other cognitive domains. Gait was assessed during single and dual task conditions. Falls data were collected prospectively using monthly calendars. Negative binomial regression quantified risk ratios (RR). After adjusting for age, gender and the number of falls in the year prior to the study, only the EF index (RR: .85; CI: .74-.98, p = .021), the attention index (RR: .84; CI: .75-.94, p = .002) and dual tasking gait variability (RR: 1.11; CI: 1.01-1.23; p = .027) were associated with future fall risk. Other cognitive function measures were not related to falls. Survival analyses indicated that subjects with the lowest EF scores were more likely to fall sooner and more likely to experience multiple falls during the 66 months of follow-up (p
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identifier ISSN: 1932-6203
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1932-6203
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source Publicly Available Content Database; PubMed Central
subjects Accidental Falls
Adult
Adults
Age
Aged
Biology
Calendars
Cognition
Cognition & reasoning
Cognition - physiology
Cognition Executive Function Executive Function Gait
Cognitive ability
Cognitive therapy
Communities
Community
Dementia
Dementia disorders
Engineering
Executive function
Executive Function - physiology
Falls
Female
Follow-Up Studies
Gait
Gait - physiology
Health risks
Humans
Information processing
Laws, regulations and rules
Male
Medical research
Medicine
Memory
Neurology
Older people
Prospective Studies
Regression analysis
Risk assessment
Risk Factors
Survival Analysis
Time Factors
Walking
title Executive function and falls in older adults: New findings from a five-year prospective study link fall risk to cognition
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