Secondary Prevention: Cognitive Status as an Indicator of Adults at Greater Risk for Falls

Emerging literature suggests that mobility and cognition are strongly associated.  Multiple studies have demonstrated that decline in gait speed precedes cognitive decline among healthy older adults.  Likewise, epidemiological data supports a negative association between cognition and older adult falls.  Certain cognitive domains, including executive functions (EF) typically decline with age; however, EF decline is more pronounced in older adults with a history of falling and poor balance than in older non-fallers. 

A small number of intervention studies, including three conducted by our research team, provide evidence that regimented cognitive training improves mobility among older adults.  The purpose of this presentation is to review findings from these three studies.

We conducted two RCTs to test the hypothesis that a 10-week cognitive training intervention improves mobility in cognitively intact older adults. Older adult participants (N=96) at independent living communities (STUDY1) and senior centers (STUDY2) were randomized to a cognitive training intervention or control. Outcomes collected at baseline and 10 weeks included gait speed, distracted gait speed, Timed Up and Go (TUG), and Berg Balance Scale (BBS).

We also conducted a pre-post program evaluation among cognitively impaired older adults to examine the change in balance following a 10-week cognitive training intervention. Participants (N=20) were recruited from an adult day care program (STUDY 3). Balance was measured by the 4-position balance stand and TUG at baseline and 10 weeks. 

Findings support that adults with cognitive degradation are at risk for falls and cognitive training is one approach toward secondary prevention among this cohort.