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Auteur Serena S. Paul
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Sensorimotor, Cognitive, and Affective Functions Contribute to the Prediction of Falls in Old Age and Neurologic Disorders: An Observational Study / Kimberley S. van Schooten in Archives of Physical Medicine and Rehabilitation, Vol. 102, n° 5 (2021)
Titre : Sensorimotor, Cognitive, and Affective Functions Contribute to the Prediction of Falls in Old Age and Neurologic Disorders: An Observational Study Type de document : Article Auteurs : Kimberley S. van Schooten ; Morag E. Taylor ; Jacqueline C.T. Close ; Jennifer C. Davis ; Serena S. Paul ; Colleen Canning ; Mark D. Latt ; Phu Hoang ; Nicole A. Kochan ; Perminder S. Sachdev ; Henry Brodaty ; Catherine M. Dean ; Femke Hulzinga ; Stephen R. Lord ; Kim Delbaere Année de publication : 2021 Article en page(s) : p. 874-880 Note générale : https://doi.org/10.1016/j.apmr.2020.10.134 Langues : Anglais (eng) Descripteurs : HE Vinci
Chutes accidentelles ; Cognition ; Cortex sensorimoteur ; Dépression ; Réadaptation
Résumé : Objective
To determine whether impairments across cognitive and affective domains provide additional information to sensorimotor deficits for fall prediction among various populations.
We pooled data from 5 studies for this observational analysis of prospective falls.
Community or low-level care facility.
Older people (N=1090; 74.0±9.4y; 579 female); 500 neurologically intact (NI) older people and 3 groups with neurologic disorders (cognitive impairment, n=174; multiple sclerosis (MS), n=111; Parkinson disease, n=305).
Main Outcome Measures
Sensorimotor function was assessed with the Physiological Profile Assessment, cognitive function with tests of executive function, affect with questionnaires of depression, and concern about falling with falls efficacy questionnaires.
These variables were associated with fall incidence rates, obtained prospectively over 6-12 months.
Poorer sensorimotor function was associated with falls (incidence rate ratio [95% CI], 1.46 [1.28-1.66]). Impaired executive function was the strongest predictor of falls overall (2.91 [2.27-3.73]), followed by depressive symptoms (2.07 [1.56-2.75]) and concern about falling (2.02 [1.61-2.55]). Associations were similar among groups, except for a weaker relationship with executive impairment in NI persons and a stronger relationship with concern about falling in persons with MS. Multivariable analyses showed that executive impairment, poorer sensorimotor performance, depressive symptoms, and concern about falling were independently associated with falls.
Deficits in cognition (executive function) and affect (depressive symptoms) and concern about falling are as important as sensorimotor function for fall prediction. These domains should be included in fall risk assessments for older people and clinical groups.
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in Archives of Physical Medicine and Rehabilitation > Vol. 102, n° 5 (2021) . - p. 874-880[article]