The Association Between Social Engagement, Mild Cognitive Impairment, and Falls Among Older Primary Care Patients
To examine associations between mild cognitive impairment (MCI) and falls among primary care patients, and to investigate whether social engagement (SE) modifies these associations. Cross sectional analysis using baseline data from an observational cohort study. Primary care. Community-dwelling olde...
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| Veröffentlicht in: | Archives of physical medicine and rehabilitation 2019-08, Vol.100 (8), p.1499-1505 |
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| creator | Quach, Lien T. Ward, Rachel E. Pedersen, Mette M. Leveille, Suzanne G. Grande, Laura Gagnon, David R. Bean, Jonathan F. |
| description | To examine associations between mild cognitive impairment (MCI) and falls among primary care patients, and to investigate whether social engagement (SE) modifies these associations.
Cross sectional analysis using baseline data from an observational cohort study.
Primary care.
Community-dwelling older adults (N=430) at risk of mobility decline with a mean age of 76.6 years (range 65-96y).
The number of falls in the past year was reported at the baseline interview. MCI was identified using a cutoff of 1.5 SD below the age-adjusted mean on at least 2 of the standardized cognitive performance tests. SE (eg, keeping in touch with friends and family, volunteering, participating social activities…) was assessed with the Late Life Function and Disability Instrument, and required a score above the median value 49.5 out of 100.
MCI was present among 42% of participants and 42% reported at least 1 fall in the preceding year. Using generalized estimating equations, MCI was associated with a 77% greater rate of falls (P |
| doi_str_mv | 10.1016/j.apmr.2019.01.020 |
| format | Article |
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Cross sectional analysis using baseline data from an observational cohort study.
Primary care.
Community-dwelling older adults (N=430) at risk of mobility decline with a mean age of 76.6 years (range 65-96y).
The number of falls in the past year was reported at the baseline interview. MCI was identified using a cutoff of 1.5 SD below the age-adjusted mean on at least 2 of the standardized cognitive performance tests. SE (eg, keeping in touch with friends and family, volunteering, participating social activities…) was assessed with the Late Life Function and Disability Instrument, and required a score above the median value 49.5 out of 100.
MCI was present among 42% of participants and 42% reported at least 1 fall in the preceding year. Using generalized estimating equations, MCI was associated with a 77% greater rate of falls (P<.05). There was a statistically significant interaction between SE and MCI on the rate of falls (P<.01), such that at a high level of SE, MCI was not statistically associated with falls (P=.83). In participants with lower levels of SE, MCI is associated with 1.3 times greater rate of falls (P<.01).
While MCI is associated with a greater risk for falls, higher levels of SE may play a protective role.
•Among older primary care patients, 42% exhibited MCI and self-reported falls in the prior year.•Mild cognitive impairment is associated with an increased fall rate in the prior year.•Among patients with lower levels of social engagement, MCI is associated with a higher fall rate.•Social engagement may be an important priority in fall treatment programs for MCI patients.</description><identifier>ISSN: 0003-9993</identifier><identifier>EISSN: 1532-821X</identifier><identifier>DOI: 10.1016/j.apmr.2019.01.020</identifier><identifier>PMID: 30825422</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Accidental Falls ; Aged ; Aged, 80 and over ; Cognitive Dysfunction - physiopathology ; Cross-Sectional Studies ; Falls ; Female ; Humans ; Independent Living ; Male ; Mild cognitive impairment ; Primary Health Care ; Rehabilitation ; Risk Factors ; Social Behavior</subject><ispartof>Archives of physical medicine and rehabilitation, 2019-08, Vol.100 (8), p.1499-1505</ispartof><rights>2019 American Congress of Rehabilitation Medicine</rights><rights>Copyright © 2019 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-3a1d214764654b507edc454dcd260a33f568e3c8ce9c43f1562aa791267b125c3</citedby><cites>FETCH-LOGICAL-c455t-3a1d214764654b507edc454dcd260a33f568e3c8ce9c43f1562aa791267b125c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0003999319301121$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30825422$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Quach, Lien T.</creatorcontrib><creatorcontrib>Ward, Rachel E.</creatorcontrib><creatorcontrib>Pedersen, Mette M.</creatorcontrib><creatorcontrib>Leveille, Suzanne G.</creatorcontrib><creatorcontrib>Grande, Laura</creatorcontrib><creatorcontrib>Gagnon, David R.</creatorcontrib><creatorcontrib>Bean, Jonathan F.</creatorcontrib><title>The Association Between Social Engagement, Mild Cognitive Impairment, and Falls Among Older Primary Care Patients</title><title>Archives of physical medicine and rehabilitation</title><addtitle>Arch Phys Med Rehabil</addtitle><description>To examine associations between mild cognitive impairment (MCI) and falls among primary care patients, and to investigate whether social engagement (SE) modifies these associations.
Cross sectional analysis using baseline data from an observational cohort study.
Primary care.
Community-dwelling older adults (N=430) at risk of mobility decline with a mean age of 76.6 years (range 65-96y).
The number of falls in the past year was reported at the baseline interview. MCI was identified using a cutoff of 1.5 SD below the age-adjusted mean on at least 2 of the standardized cognitive performance tests. SE (eg, keeping in touch with friends and family, volunteering, participating social activities…) was assessed with the Late Life Function and Disability Instrument, and required a score above the median value 49.5 out of 100.
MCI was present among 42% of participants and 42% reported at least 1 fall in the preceding year. Using generalized estimating equations, MCI was associated with a 77% greater rate of falls (P<.05). There was a statistically significant interaction between SE and MCI on the rate of falls (P<.01), such that at a high level of SE, MCI was not statistically associated with falls (P=.83). In participants with lower levels of SE, MCI is associated with 1.3 times greater rate of falls (P<.01).
While MCI is associated with a greater risk for falls, higher levels of SE may play a protective role.
•Among older primary care patients, 42% exhibited MCI and self-reported falls in the prior year.•Mild cognitive impairment is associated with an increased fall rate in the prior year.•Among patients with lower levels of social engagement, MCI is associated with a higher fall rate.•Social engagement may be an important priority in fall treatment programs for MCI patients.</description><subject>Accidental Falls</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cognitive Dysfunction - physiopathology</subject><subject>Cross-Sectional Studies</subject><subject>Falls</subject><subject>Female</subject><subject>Humans</subject><subject>Independent Living</subject><subject>Male</subject><subject>Mild cognitive impairment</subject><subject>Primary Health Care</subject><subject>Rehabilitation</subject><subject>Risk Factors</subject><subject>Social Behavior</subject><issn>0003-9993</issn><issn>1532-821X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9Ud1rFDEQD6LYa_Uf8EHy6IO7ZpLNfoAI59FqodKCFXwLuWRum2M3uSZ7J_73zbG16ItPw8zvY4b5EfIGWAkM6g_bUu_GWHIGXcmgZJw9IwuQghcth5_PyYIxJoqu68QJOU1pm9taCnhJTgRruaw4X5D72zuky5SCcXpywdPPOP1C9PT7cTLQc9_rHkf003v6zQ2WrkLv3eQOSC_HnXZxhrS39EIPQ6LLMfieXg8WI72JbtTxN13piPQm-2duekVebPSQ8PVjPSM_Ls5vV1-Lq-svl6vlVWEqKadCaLAcqqaualmtJWvQZqCyxvKaaSE2sm5RmNZgZyqxAVlzrZsOeN2sgUsjzsin2Xe3X49ZnHdHPajdfJMK2ql_Ee_uVB8OquEtbxjPBu8eDWK432Oa1OiSwWHQHsM-KQ5tI0F2EjKVz1QTQ0oRN09rgKljVmqrjlmpY1aKgcpZZdHbvw98kvwJJxM-zgTMbzo4jCqZ_EKD1kU0k7LB_c__AZ-Apmo</recordid><startdate>20190801</startdate><enddate>20190801</enddate><creator>Quach, Lien T.</creator><creator>Ward, Rachel E.</creator><creator>Pedersen, Mette M.</creator><creator>Leveille, Suzanne G.</creator><creator>Grande, Laura</creator><creator>Gagnon, David R.</creator><creator>Bean, Jonathan F.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190801</creationdate><title>The Association Between Social Engagement, Mild Cognitive Impairment, and Falls Among Older Primary Care Patients</title><author>Quach, Lien T. ; Ward, Rachel E. ; Pedersen, Mette M. ; Leveille, Suzanne G. ; Grande, Laura ; Gagnon, David R. ; Bean, Jonathan F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-3a1d214764654b507edc454dcd260a33f568e3c8ce9c43f1562aa791267b125c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Accidental Falls</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cognitive Dysfunction - physiopathology</topic><topic>Cross-Sectional Studies</topic><topic>Falls</topic><topic>Female</topic><topic>Humans</topic><topic>Independent Living</topic><topic>Male</topic><topic>Mild cognitive impairment</topic><topic>Primary Health Care</topic><topic>Rehabilitation</topic><topic>Risk Factors</topic><topic>Social Behavior</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Quach, Lien T.</creatorcontrib><creatorcontrib>Ward, Rachel E.</creatorcontrib><creatorcontrib>Pedersen, Mette M.</creatorcontrib><creatorcontrib>Leveille, Suzanne G.</creatorcontrib><creatorcontrib>Grande, Laura</creatorcontrib><creatorcontrib>Gagnon, David R.</creatorcontrib><creatorcontrib>Bean, Jonathan F.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Archives of physical medicine and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Quach, Lien T.</au><au>Ward, Rachel E.</au><au>Pedersen, Mette M.</au><au>Leveille, Suzanne G.</au><au>Grande, Laura</au><au>Gagnon, David R.</au><au>Bean, Jonathan F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Association Between Social Engagement, Mild Cognitive Impairment, and Falls Among Older Primary Care Patients</atitle><jtitle>Archives of physical medicine and rehabilitation</jtitle><addtitle>Arch Phys Med Rehabil</addtitle><date>2019-08-01</date><risdate>2019</risdate><volume>100</volume><issue>8</issue><spage>1499</spage><epage>1505</epage><pages>1499-1505</pages><issn>0003-9993</issn><eissn>1532-821X</eissn><abstract>To examine associations between mild cognitive impairment (MCI) and falls among primary care patients, and to investigate whether social engagement (SE) modifies these associations.
Cross sectional analysis using baseline data from an observational cohort study.
Primary care.
Community-dwelling older adults (N=430) at risk of mobility decline with a mean age of 76.6 years (range 65-96y).
The number of falls in the past year was reported at the baseline interview. MCI was identified using a cutoff of 1.5 SD below the age-adjusted mean on at least 2 of the standardized cognitive performance tests. SE (eg, keeping in touch with friends and family, volunteering, participating social activities…) was assessed with the Late Life Function and Disability Instrument, and required a score above the median value 49.5 out of 100.
MCI was present among 42% of participants and 42% reported at least 1 fall in the preceding year. Using generalized estimating equations, MCI was associated with a 77% greater rate of falls (P<.05). There was a statistically significant interaction between SE and MCI on the rate of falls (P<.01), such that at a high level of SE, MCI was not statistically associated with falls (P=.83). In participants with lower levels of SE, MCI is associated with 1.3 times greater rate of falls (P<.01).
While MCI is associated with a greater risk for falls, higher levels of SE may play a protective role.
•Among older primary care patients, 42% exhibited MCI and self-reported falls in the prior year.•Mild cognitive impairment is associated with an increased fall rate in the prior year.•Among patients with lower levels of social engagement, MCI is associated with a higher fall rate.•Social engagement may be an important priority in fall treatment programs for MCI patients.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30825422</pmid><doi>10.1016/j.apmr.2019.01.020</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Accidental Falls Aged Aged, 80 and over Cognitive Dysfunction - physiopathology Cross-Sectional Studies Falls Female Humans Independent Living Male Mild cognitive impairment Primary Health Care Rehabilitation Risk Factors Social Behavior |
| title | The Association Between Social Engagement, Mild Cognitive Impairment, and Falls Among Older Primary Care Patients |
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