Relative Contribution of Mobility and Cognition to Falls and Fear of Falling in Cognitive Impaired Older Adults

• Main Authors: Yi Lin, 林沂
• Other Authors: Ming- Hsia Hu
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/46209281972388677647

碩士 === 國立臺灣大學 === 物理治療學研究所 === 102 === With aging of the world population, “Falls” and “Fear of falling” become an important issue which may influence health and independence of the older adults. The incidence of falls and fear of falling are twice or more on cognitive impaired older adults. The relationship between falls and fear of falling on cognitive impaired older adults remains unclear. Mobility and cognition may be the main factors that influence falls and fear of falling, and the interaction between these two factors has been suggest recently. This study aims to find out the relative contribution of mobility and cognition to falls and fear of falling in. The participants in this study were cognitive impaired community-dwelling older adults recruited from National Taiwan University hospital and day care centers in Neihu and Songshan. The basic data (age, gender, fall history, Barthel index) of each subject were collected. The assessment tool including Iconographical Falls Efficacy Scale (Icon-FES, fear of falling), Timed ”Up &; Go” test (TUG, mobility), Mini-Mental Status Examination (MMSE, cognition), Saint Louis University Mental Status Examination (SLUMS, cognition), Timed ”Up &; Go” and Subtraction by Threes dual task (interaction between mobility and cognition). One month after the assessment, the assessor will recorded the number of falls by calling the subjects. The descriptive statistics analysis were used to describe the basic characteristics of the participants, the correlation and regression analysis were used to understand the relative contribution of those factors to falls and fear of falling. This study recruited 57 participants (17 male and 40 female), the average age was 79.7 years old. 47.4% severe cognitive impaired older adults were included in this study. The average number of falls before this assessment is 1.09 in one year, range from 0 to 12. The average number of falls after the assessment is 0.14 in 1 month, range from 0 to 1. For numbers of falls, the correlation analysis shows positive relationship with MMSE scores (retrospective/prospective r= 0.165/0.234), negative relationship with dual task cost (retrospective/prospective r= -0.185/-0.061). The order of important contributors for falls is cognition (|Beta|=0.371), mobility (|Beta|=0.283) and dual task performance (|Beta|=0.023). For fear of falling, the correlation analysis shows positive relationship with TUG seconds (r= 0.373, p=0.004), negative relationship with MMSE scores (r= -0.154), dual task cost (r= -0.088). The order of important contributors for fear of falling is mobility (|Beta|=0.289), cognition (|Beta|=0.084) and dual task performance (|Beta|=0.06). In conclusion, fall incidence may be higher in those who have better cognition status in cognitive impaired community-dwelling older adults, and the mobility may be an important factor for fear of falling due to significant high correlation. the dual task performance have low correlation and relative contribution to the number of falls, whether or not to use this kind of assessment for assessing clinical cognitive impaired older adults needs more research to find out. The result of this study can be a useful concept for designing clinical fall-prevention program.