Cognitive impairment is associated with the absence of fear of falling in community-dwelling frail older adults

AimThe purpose of the present study was to explore the association between cognitive function and fear of falling in frail/non-frail older adults in a community setting. MethodsWe recruited 483 community-dwelling older adults aged 65 years and older (mean age 73.35.1 years, 68.3% women). Fear of falling was assessed using a yes/no question, Are you afraid of falling? Cognitive function was measured using the Mini-Mental State Examination. The five subscores of the examination were also recorded. We used the frailty criteria developed by the Cardiovascular Health Study, and divided the participants into non-frail and frail groups according to the number of affected domains. The statistical analyses were carried out separately for these two groups. ResultsA multiple logistic regression analysis showed that, in frail older adults, cognitive impairment was significantly associated with the absence of fear of falling (OR 0.04, 95% CI 0.00-0.50, P=0.012). In addition, a stepwise multivariate logistic regression analysis showed that the score on the attention and calculation subsection of the Mini-Mental State Examination was positively associated with the presence of fear of falling in frail older adults (OR 1.83, 95% CI 1.08-3.12, P=0.026). In contrast, cognitive impairment was not associated with fear of falling in non-frail older adults. ConclusionsThe results suggest that cognitive impairment, especially that in executive function, is associated with the absence of fear of falling in community-dwelling frail older adults. Geriatr Gerontol Int 2017; 17: 232-238.