The Association between Social Engagement, Mild Cognitive Impairment and Falls among Older Primary Care Patients

Publication date: Available online 27 February 2019

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Lien T. Quach, Rachel E. Ward, Mette M. Pedersen, Suzanne G. Leveille, Laura Grande, David R. Gagnon, Jonathan F. Bean

Abstract

Objectives

To examine associations between mild cognitive impairment (MCI) and falls among primary care patients, and to investigate whether social engagement (SE) modifies these associations.

Design

Cross sectional analysis using baseline data from an observational cohort study.

Setting

Primary Care

Participants

430 community-dwelling older adults at risk of mobility decline with a mean age of 76.6 (range 65 to 96).

Main outcome measures

The number of falls in the past year was reported at the baseline interview. MCI was identified using a cutoff of 1.5 SD below the age-adjusted mean on at least two of the standardized cognitive performance tests. SE (e.g. keeping in touch with friends and family, volunteering, and participating social activities…) was assessed with the Late Life Function and Disability Instrument, and required a score above the median value 49.5 out of 100.

Results

MCI was present among 42% of participants and 42% reported at least one fall in the preceding year. Using Generalized Estimating Equations, MCI was associated with a 77% greater rate of falls (p<0.05). There was a statistically significant interaction between SE and MCI on the rate of falls (p<0.01), such that at a high level of SE, MCI was not statistically associated with falls (p=0.83). In participants with lower levels of SE, MCI is associated with 1.3 greater rate of falls (p<0.01).

Conclusions

While MCI is associated with a greater risk for falls, higher levels of SE may play a protective role.

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