Beyond balance and mobility, contributions of cognitive function to falls in older adults with cardiovascular disease

OBJECTIVES: Older adults with cardiovascular disease (CVD) are at risk for cognitive impairment. Cognitive function is associated with falls in older adults however it is unknown if a relationship exists between cognitive function and falls in CVD. The aim of this study was to examine the contributions of cognitive function on falls in older adults with CVD. METHODS: A secondary analysis was performed on data from the Health and Retirement Study cohort 2010 (N=3413) of older adults with CVD. Group assignment was based on falls history (yes/no) within the two years prior to the survey. Demographic (age, education, gender, marital status), physical (strength, balance, physical activity, and mobility) and cognitive (immediate and delayed recall, orientation, semantic verbal fluency, numeracy) information was extracted to characterize the sample. Comparisons between groups were completed for all of these variables. Logistic regression was performed to examine associations between each of the cognitive variables and falls while controlling for age, gender, marital status, education, and BMI. RESULTS: Demographic (age, gender, marital status, and education), physical (grip strength, tandem stance time, and gait speed), and cognitive (orientation, immediate and delayed recall) variables differed by falls history (p<0.05). After controlling for confounding, immediate recall was the only significant predictor of falls (OR=1.09, 95% CI=1.01-1.17) (Nagelkerke R(2)=0.037, χ(2)=35.14, p<0.05) with correctly classifying 65.9% of cases. CONCLUSIONS: In older adults with CVD, cognitive and physical functions are more impaired in those with a falls history. Screening for cognitive function, specifically immediate recall, should be a part of the management of falls in this population.