Blackwood Jennifer, Gore Shweta
Physical Therapy Department, University of Michigan-Flint, USA.
MGH Institute of Health Professions, Boston, MA, USA.
J Frailty Sarcopenia Falls. 2019 Sep 1;4(3):65-70. doi: 10.22540/JFSF-04-065. eCollection 2019 Sep.
Older adults with cardiovascular disease (CVD) are at risk for cognitive impairment. Cognitive function is associated with falls in older adults however it is unknown if a relationship exists between cognitive function and falls in CVD. The aim of this study was to examine the contributions of cognitive function on falls in older adults with CVD.
A secondary analysis was performed on data from the Health and Retirement Study cohort 2010 (N=3413) of older adults with CVD. Group assignment was based on falls history (yes/no) within the two years prior to the survey. Demographic (age, education, gender, marital status), physical (strength, balance, physical activity, and mobility) and cognitive (immediate and delayed recall, orientation, semantic verbal fluency, numeracy) information was extracted to characterize the sample. Comparisons between groups were completed for all of these variables. Logistic regression was performed to examine associations between each of the cognitive variables and falls while controlling for age, gender, marital status, education, and BMI.
Demographic (age, gender, marital status, and education), physical (grip strength, tandem stance time, and gait speed), and cognitive (orientation, immediate and delayed recall) variables differed by falls history (p<0.05). After controlling for confounding, immediate recall was the only significant predictor of falls (OR=1.09, 95% CI=1.01-1.17) (Nagelkerke R=0.037, χ=35.14, p<0.05) with correctly classifying 65.9% of cases.
In older adults with CVD, cognitive and physical functions are more impaired in those with a falls history. Screening for cognitive function, specifically immediate recall, should be a part of the management of falls in this population.
患有心血管疾病（CVD）的老年人有认知障碍风险。认知功能与老年人跌倒有关，然而，认知功能与CVD患者跌倒之间是否存在关联尚不清楚。本研究的目的是探讨认知功能对患有CVD的老年人跌倒的影响。
对2010年健康与退休研究队列中患有CVD的老年人的数据（N = 3413）进行二次分析。根据调查前两年内的跌倒史（是/否）进行分组。提取人口统计学信息（年龄、教育程度、性别、婚姻状况）、身体信息（力量、平衡、身体活动和活动能力）和认知信息（即刻和延迟回忆、定向、语义语言流畅性、计算能力）以描述样本特征。对所有这些变量进行组间比较。进行逻辑回归分析，在控制年龄、性别、婚姻状况、教育程度和体重指数的同时，检验每个认知变量与跌倒之间的关联。
人口统计学变量（年龄、性别、婚姻状况和教育程度）、身体变量（握力、单脚站立时间和步速）和认知变量（定向、即刻和延迟回忆）因跌倒史而异（p<0.05）。在控制混杂因素后，即刻回忆是跌倒的唯一显著预测因素（OR = 1.09，95%CI = 1.01 - 1.17）（Nagelkerke R = 0.037，χ = 35.14，p<0.05），正确分类率为65.9%。
在患有CVD的老年人中，有跌倒史的人的认知和身体功能受损更严重。对认知功能，特别是即刻回忆进行筛查，应成为该人群跌倒管理的一部分。
