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Titre : | Mild Neurocognitive Disorder, Social Engagement, and Falls Among Older Primary Care Patients (2023) |
Auteurs : | Lien T. Quach ; Mette M. Pedersen ; Elisa F. Ogawa ; Rachel E. Ward ; David R. Gagnon ; Avron Spiro ; Jeffrey A. Burr ; Jane A. Driver ; Michael Gaziano ; Amar Dhand ; Jonathan F. Bean |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 104, n° 4, 2023) |
Article en page(s) : | p. 541-546 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Chutes accidentelles ; Dysfonctionnement cognitif ; Participation sociale ; Réadaptation |
Résumé : | 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. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999322016756 |