Slow Processing Speed Predicts Falls in Older Adults With a Falls History: 1-Year Prospective Cohort Study

• Autores: Jennifer C. Davis, John R. Best, Karim M. Khan, Larry Díaz, Stephen R. Lord, Kim Delbaere, Chun Liang, Winnie Cheung, Wency Chan, Teresa Liu Ambrose
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 65, Nº. 5, 2017, págs. 916-923
• Idioma: inglés
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• Resumen

  • Background/Objectives A previous fall is a strong predictor of future falls. Recent epidemiologic data suggest that deficits in processing speed predict future injurious falls. Our primary objective was to determine a parsimonious predictive model of future falls among older adults who experienced ≥1 fall in the past 12 months based on the following categories: counts of (1) total, (2) indoor, (3) outdoor or (4) non-injurious falls; (5) one mild or severe injury fall (yes vs no); (6) an injurious instead of a non-injurious fall; and (7) an outdoor instead of an indoor fall.

    Design 12-month prospective cohort study.

    Setting Vancouver Falls Prevention Clinic, Canada (www.fallsclinic.ca).

    Participants Two-hundred and eighty-eight community-dwelling older adults aged ≥70 years with a history of ≥1 fall resulting in medical attention in the previous 12 months.

    Measurements We employed principal component analysis to reduce the baseline predictor variables to a smaller set of five factors (i.e., processing speed, working memory, emotional functioning, physical functioning and body composition/fall risk profile). Second, we used the extracted five factors as predictors in regression models predicting the incidence of falls over a 12-month prospective observation period. We conducted regression analyses for the seven falls-related categories (defined above).

    Results Among older adults with a falls history, processing speed was the most consistent predictor of future falls; poorer processing speed predicted a greater number of total, indoor, outdoor, and non-injurious falls, and a greater likelihood of experiencing at least one mild or severe injurious fall (all P values < .01).

    Conclusion Poorer performance on the processing speed factor, a trainable factor, was independently associated with the most costly type of falls–injurious falls.