Abstract
Objectives
(1) To estimate the association between social engagement (SE) and falls; (2) To examine
the relation between mild neurocognitive disorder (MNCD) and falls by different levels
of SE.
Design
We performed a secondary data analysis using prospective cohort study design.
Setting
Primary care.
Participants
A total of 425 older adult primary care patients at risk for mobility decline (N=425).
As previously reported, at baseline, 42% of participants exhibit MNCD.
Main Outcome Measures
The outcome variable was the number of falls during 2 years of follow-up. Exposure
variables at baseline included (1) MNCD identified using a cut-off of 1.5 SD below
the age-adjusted mean on at least 2 measures within a cognitive performance battery
and (2) SE, which was assessed using the social component of the Late-Life Function
and Disability Instrument. High SE was defined as having a score ≥ median value (≥49
out of 100). All models were adjusted for age, sex, education, marital status, comorbidities,
and pain status.
Results
Over 2 years of follow-up, 48% of participants fell at least once. MNCD was associated
with a higher rate of falls, adjusting for the covariates (Incidence Rate Ratio=1.6,
95% confidence interval: 1.1-2.3). There was no significant association between MNCD
and the rate of falls among people with high SE. In participants with low SE (having
a score less than 49.5 out 100), MNCD was associated with a higher rate of falls as
compared with participants with no neurocognitive disorder (No-NCD).
Conclusions
Among participants with low SE, MNCD was associated with a higher rate of falls, but
not among participants with high SE. The findings suggest that high SE may be protective
against falls among older primary care patients with MNCD.
Keywords
List of abbreviations:
Boston RISE (Boston Rehabilitative Impairment Study of the Elderly), CI (confidence interval), HVLT-R (Hopkins Verbal Learning Test, Revised), MNCD (mild neurocognitive disorder), SE (social engagement), TMT (Trail Making Test)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 10, 2022
Accepted:
October 22,
2022
Received in revised form:
October 18,
2022
Received:
June 29,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
This work was supported by the National Institutes of Health grant P2C-HD065702 and the Boston Claude D. Pepper Older Americans Independence Center under grant P30-AG031679. This work also was supported by the National Institute on Aging (R01-AG032052) and (K24-2 K24 AG069176-06 to J.F.B.). The sponsors played no role in the design, analysis, or reporting of this study.
Disclosures: none.
Identification
Copyright
© 2022 by the American Congress of Rehabilitation Medicine.
