Nursing home worker helps a resident stand up

Older adults are more likely to sustain repeated falls if they develop frailty and cognitive impairment simultaneously, according to a new study. Clinicians should take note when screening seniors for falls risk, investigators say.

The researchers examined whether the timing of physical frailty and cognitive decline onset impacts falls incidence. To do so, they examined data from the National Health Aging Trends Study from 2011 to 2017. More than 1,300 adults aged 65 years and older were assessed for frailty and self-reported falls annually. None had frailty or cognitive impairment at baseline.

Over a five-year period, 62% of participants developed cognitive impairment first (CI first), 21% developed frailty first. Among 16% of participants, cognitive impairment and frailty co-occurred within a one-year period.  

Overall, 34% fell at least once in a one year period after the onset of physical frailty and/or cognitive impairment, investigators reported. Participants who developed CI and frailty at roughly the same time had a more than twofold increased risk of repeated falls than the CI-first cohort. There were no significant differences found between the frailty-first and CI-first cohorts.

Notably, the order of onset was not associated with risk of a single fall, reported Qian-Li Xue, PhD, of the Johns Hopkins Bloomberg School of Public Health, and colleagues.

“Fall risk screening should consider the order and timing of onset of physical frailty and cognitive impairment,” the authors concluded.

The study was published in JAMDA.

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