Severity of cognitive impairment, fear of falling and risk of falls in the elderly: Results from the Hispanic Established Population for Epidemiological Study of the Elderly (HEPESE): 2004-2007

Background: While cognitive impairment may predict the risk of falls in the elderly, the association of the severity of cognitive impairment, fear of falling and falls in the elderly is still not well understood.

Method: In this retrospective cohort analysis, data of 1447 individuals aged 75 years and above participating in Wave 5 and 6 of the HEPESE study was analysed. Cognitive status and fear of falling was assessed at baseline (Wave 5) and the event of at least one fall was determined at the two year follow-up (Wave 6). Logistic regression was used to assess the association between severity of cognitive impairment, fear of falling and fall(s) after adjusting for demographic factors, arthritis, depression and ADL.

Results: Study participants had a mean age of 81.3 ± 4.7 years and 36.9% (n=534 ) were males. More than one third of the study population (35.14%, n=507) reported falls between baseline and follow-up visit. Prior to adjustment, severe cognitive impairment was associated with an increased risk of falls [OR 1.209 (95% CI: 1.111-1.619)]. However, after adjustment, severity of cognitive impairment was no longer associated with risk of fall(s). After adjustment, individuals reporting to have a significant fear of falling at baseline were more likely to experience a fall [OR 1.654 (95% CI: 1.228-2.229)], compared to those with no fear of falling.

Conclusion: As fear of falling increases the risk of falls, factors that lead to fear of falling in the elderly, may be able to effectively predict the risk of falls.