Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
Tokyo Bay Rehabilitation Hospital, Chiba, Japan.
Aging Clin Exp Res. 2018 May;30(5):457-462. doi: 10.1007/s40520-017-0799-3. Epub 2017 Jul 19.
The association between subjective cognitive decline and falls has not been clearly determined.
Our aim was to explore the effect of subjective cognitive decline on falls in community-dwelling older adults with or without objective cognitive decline.
We included 470 older adults (mean age 73.6 ± 5.2; 329 women) living in the community and obtained data on fall history directly from the participants. Subjective cognitive decline was assessed using a self-administered question. Objective cognitive function was measured using the Mini-Mental State Examination. Statistical analyses were carried out separately for participants with objective cognitive decline and those without.
A multiple logistic regression analysis showed that, among participants without objective cognitive decline, subjective cognitive decline was positively associated with falls [OR 1.91; 95% confidence interval (CI) 1.17-3.12; p = 0.01). Conversely, among participants with objective cognitive decline, subjective cognitive decline was negatively associated with falls (OR 0.07; 95% CI 0.01-0.85, p = 0.04).
The result suggests that the objective-subjective disparity may affect falls in community-dwelling older adults.
The presence of subjective cognitive decline was significantly positively associated with falls among cognitively intact older adults. However, among their cognitively impaired peers, the absence of subjective cognitive decline was positively associated with falls.
主观认知下降与跌倒之间的关联尚未明确。
我们旨在探讨有或无客观认知下降的社区居住老年人中主观认知下降对跌倒的影响。
我们纳入了 470 名年龄在 73.6±5.2 岁(329 名为女性)的社区居住老年人,并直接从参与者那里获得了跌倒史数据。使用自我管理问卷评估主观认知下降。使用简易精神状态检查评估客观认知功能。分别对有客观认知下降和无客观认知下降的参与者进行统计分析。
多因素逻辑回归分析显示,在无客观认知下降的参与者中,主观认知下降与跌倒呈正相关[比值比 1.91;95%置信区间 1.17-3.12;p=0.01]。相反,在有客观认知下降的参与者中,主观认知下降与跌倒呈负相关(比值比 0.07;95%置信区间 0.01-0.85,p=0.04)。
结果表明,客观-主观差异可能会影响社区居住老年人的跌倒。
在认知功能正常的老年人中,存在主观认知下降与跌倒显著正相关。然而,在认知功能受损的老年人中,没有主观认知下降与跌倒正相关。