Executive function predicts decline in mobility after a fall: The MYHAT study

• Published in: Experimental gerontology 2020-08, Vol.137, p.110948-110948, Article 110948
• Main Authors: Hughes, Tiffany F., Beer, Joanne C., Jacobsen, Erin, Ganguli, Mary, Chang, Chung-Chou H., Rosano, Caterina
• Format: Article
• Language: English
• Subjects: Accidental Falls; Aged; Cognition; Cognition Disorders; Executive Function; Falls; Healthy Aging; Humans; Mobility
• ISSN: 0531-5565; 1873-6815
• DOI: 10.1016/j.exger.2020.110948

Evidence suggests that better cognitive functioning is associated with better mobility in older age. It is unknown whether older adults with better cognitive function are more resilient to mobility decline after a fall. Participants from the Monongahela Youghiogheny Healthy Aging Team (MYHAT) study were followed annually for up to 9 years for incident falls. We examined one-year (mean 1.0 year, SD 0.1) change in mobility pre- to post-fall using the Timed Up and Go (TUG) in relation to pre-fall cognition (executive function, attention, memory, and visuospatial function) among incident fallers (n = 598, mean age 79.1, SD = 7.0). Linear regression models tested the association of cognition with change in TUG. Interaction terms were tested to explore if age, sex, body mass index, physical activity, depressive symptoms, or visual acuity modified the associations of cognition and mobility among fallers. The association between cognition and one-year change in TUG was also tested in a comparison sample of non-fallers (n = 442, mean age 76.3, SD = 7.2). Overall, mobility decline was greater in fallers compared to non-fallers. In fully-adjusted models, higher executive function, but not attention, memory, or visuospatial function, was associated with less decline in mobility among incident fallers. The effect was significantly stronger for those who were older, sedentary, and had lower body mass index. Higher scores in memory tests, but not in other domains, was associated with less mobility decline among non-fallers. Higher executive function may offer resilience to mobility decline after a fall, especially among older adults with other risk factors for mobility decline. Future studies should assess whether executive function may be a helpful risk index of fall-related physical functional decline in geriatric settings. •Older adults who fall have more decline in mobility compared to non-fallers.•Higher executive function predicts less mobility decline after a fall.•This effect is modified by age, body mass index, and physical activity level.