THE INTERPLAY BETWEEN BASELINE COGNITIVE STATUS AND FALLS HISTORY ON CHANGES IN MEMORY AND PHYSICAL FUNCTION AMONG OLDER ADULTS: A 1-YEAR PROSPECTIVE COHORT STUDY

Abstract

Older adults with a history of falls are a risk for physical, cognitive, and functional decline. Among older adults with a recent history of falls, we aimed to determine baseline predictors of subsequent changes in aspects of cognitive, emotional, and physical functioning. Specifically, we focused on baseline cognitive status, and number of falls in the previous 12 months. We conducted a 1-year prospective cohort study that included 377 community-dwelling older adults aged ≥ 70 years with a history of ≥ 1 fall in the previous 12 months who presented to the Vancouver Falls Prevention Clinic (www.fallsclinic.ca). The Vancouver Falls Prevention Clinic provides a geriatrician based multifactorial intervention to individuals at high risk of falls. We report falls and cognitive function at baseline and examine changes between baseline and 1 year followup on cognitive, emotional, and physical functioning. Representing these aspects of cognitive, emotional and physical functioning are our key outcome measures consisting of five components derived from a principal component analysis: 1) attention and processing speed, 2) emotional functioning, 3) working memory, 4) physical functioning and 5) physical activity and comorbidities and fall risk. We used linear mixed effects models to examine the interaction of prior falls status (categorized as 1, 2 or 3 or more prior falls) and baseline MoCA score (a continuous variable) how these 5 components changed over 1 year. We observed a significant MoCA by prior falls by time interaction, F (2, 138) = 3.49, p = .03, on the working memory factor (Table 1). Among individuals with 3 or more prior falls, higher baseline MoCA score was protective of working memory performance decline over time (B = 0.17, SE = .08, p = .04). In contrast, those with ≥ 3 prior falls and lower baseline MoCA scores demonstrated the greatest decline in working memory performance (Figure 1). Baseline MoCA score did not appear to impact the trajectory of working memory performance among those with 1 or 2 prior falls.