Older People at High Risk of Falls With and Without Cognitive Impairment and Factors Related to Falls: A Cross-Sectional Study

Abstract

Cognitive impairment in older adults is associated with reduced functionality, impaired mobility, and increased fall risk, although the mechanisms linking these factors remain unclear. This study compared clinical and sociodemographic characteristics of community-dwelling older adults at high risk of falls with and without cognitive impairment and identified factors associated with the number of falls in each group. In this cross-sectional study, 118 older adults were assessed and classified as having cognitive impairment using the Mini-Mental State Examination and/or ACE-R. Sociodemographic, clinical, cognitive, psychological, functional, mobility (single- and dual-task Timed Up and Go), and fall history data were collected. Older adults with cognitive impairment (n=63) showed worse cognitive, functional, and mobility performance than those without impairment (n=55), although no difference was observed in the number of falls (p>0.05). Simple linear regression revealed that self-rated health was the only predictor of falls among individuals with cognitive impairment, whereas the number of medications predicted falls in those without impairment. Cognitive impairment is associated with greater multidimensional vulnerability, and fall-related factors differ between groups, indicating distinct risk mechanisms.