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Original Research Article

Free Access

Increased Risk for Falling Associated with Subtle Cognitive Impairment: Secondary Analysis of a Randomized Clinical Trial

Gleason C.E.a, c · Gangnon R.E.b · Fischer B.L.d · Mahoney J.E.a

Author affiliations

aSection of Geriatrics and Gerontology, Department of Medicine, and bDepartments of Biostatistics and Medical Informatics and Population Health Sciences, University of Wisconsin, cGeriatric Research, Education and Clinical Center (GRECC), and dMental Health Service, William S. Middleton Memorial Veterans Hospital, Madison, Wisc., USA

Corresponding Author

Carey E. Gleason, PhD

Section of Geriatrics, Department of Medicine, University of Wisconsin

Madison VA GRECC, Room D4211, 2500 Overlook Terrace

Madison, WI 53705 (USA)

Tel. +1 608 256 1901, ext. 17000, Fax +1 608 280 7165, E-Mail ceg@medicine.wisc.edu

Related Articles for ""

Dement Geriatr Cogn Disord 2009;27:557–563

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Abstract

Background/Aims: Having dementia increases patients’ risk for accidental falls. However, it is unknown if having mild cognitive deficits also elevates a person’s risk for falls. This study sought to clarify the relationship between subtle cognitive impairment, measured with a widely-used, clinic-based assessment, the Mini Mental State Exam (MMSE), and risk for falls. Methods: In a secondary analysis of the Kenosha County Falls Prevention Study, a randomized controlled trial targeting older adults at risk for falls, we examined the association between baseline MMSE and prospective rate of falls over 12 months in 172 subjects randomized to control group. Results: Using univariate analysis, the rate of falls increased with each unit decrease in MMSE score down to at least 22 (rate ratio 1.25, 95% confidence interval (CI) 1.09–1.45, p = 0.0026). Using stepwise multivariate regression, controlling for ability to perform activities of daily living, use of assistive device, current exercise, and arthritis, the association between MMSE score and falls rate persisted (rate ratio 1.20, 95% CI 1.03–1.40, p = 0.021). Conclusion: Minimal decrements on the MMSE were associated with elevations in rate of falls, suggesting that subtle cognitive deficits reflected in MMSE scores above a cut-off consistent with a diagnosis of dementia, can influence risk for falls.

© 2009 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Accepted: March 17, 2009
Published online: July 11, 2009
Issue release date: July 2009

Number of Print Pages: 7
Number of Figures: 1
Number of Tables: 3

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: http://www.karger.com/DEM


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