Effects of Mild Cognitive Impairment on the Development of Fear of Falling in Older Adults: A Prospective Cohort Study

Objectives: The aim of this study was to determine whether mild cognitive impairment (MCI) affects the development of fear of falling (FoF) in older adults. Design: Prospective cohort study. Setting: The Obu Study for Health Promotion in the Elderly, Japan. Participants: A total of 1700 community-dwelling people aged 65 years or older without FoF at baseline participated. Measurements: FoF and related variables, such as physical function, self-rated health, depression, and total number of medication doses, were investigated at baseline. Participants also underwent cognitive tests and were divided into cognitive healthy and MCI. Fifteen months after the baseline measurements, we collected information about the status of FoF and fall incidence during the 15-month follow-up. Results: At the 15-month follow-up survey, 452 participants (26.5%) reported the development of FoF. Logistic regression analysis showed that MCI (odds ratio [95% CI] = 1.41 [1.07-1.87]) and a fall incident (3.00 [2.23-4.07]) during follow-up independently predicted the development of FoF, after controlling for demographic factors, physical function, self-rated health, and depression. The odds ratio for the development of FoF in participants with both MCI and a fall incident compared with those without them was 7.34 (4.06-13.3), after controlling for confounding factors. Conclusion: MCI predicts the new onset of FoF in older adults, especially when they have experience with falling. Aside from the risk of falling, it is suggested that individuals with MCI are an at-risk population for FoF and related negative consequences in terms of postfall syndrome. (C) 2015 AMDA - The Society for Post-Acute and Long-Term Care Medicine.