Cognitive status and walking speed, balance and falls among older adults

Introduction: Cognitive status is associated with the loss of functional abilities including walking speed in older adults. The current study examines the association between cognition and balance, falls, and walking speed. Methods: As part of the Healthy Aging Network, a survey of neighborhood and environmental characteristics associated with walking behaviors was administered at multiple sites across the US. Multivariate analyses were conducted to examine the association between two cognitive measures (Mini-Mental Status Exam (MMSE) and the Mental Alternation Test (MAT)) and functional abilities (balance variables, walking speed, and falls) controlling for demographic and health factors. Results: Eight-hundred eighty four community dwelling adults age 65 years and older completed the survey. Three measures of balance and walking velocity (feet per second) were significantly associated with both the MMSE and the MAT at the bivariate level. There was a significant negative association between number of falls in the last 6 months and MAT scores with greater falls being associated with greater cognitive impairment. Controlling for age, gender, BMI, and self-rated health, linear regression models revealed that the association between balance measures and walking speed with cognitive measures remained significant (p<.001). Conclusion: Cognitive performance was a strong predictor of balance, walking speed and falls in older adults after accounting for demographic and health variables.