AUTHOR=Chen Huihe , Huang Lanhui , Xiang Wei , Liu Yu , Xu Jian-Wen 

TITLE=Association between cognitive frailty and falls among older community dwellers in China: A Chinese longitudinal healthy longevity survey-based study

JOURNAL=Frontiers in Aging Neuroscience

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2022.1048961

DOI=10.3389/fnagi.2022.1048961

ISSN=1663-4365

ABSTRACT=<sec><title>Background</title><p>The combined effect of cognitive impairment (CoI) and frailty on falls is controversial. This study aimed to explore whether older adults with cognitive frailty (<italic>CF</italic>) were at a higher risk of falls than those with only CoI or frailty and to present a fall prediction model based on <italic>CF.</italic></p></sec><sec><title>Methods</title><p>A total of 4,067 adults aged ≥ 60 years were included from the Chinese Longitudinal Healthy Longevity Survey through face-to-face interviews. Cognitive function and frailty were assessed using the mini-mental state examination scale and frailty index, respectively. Logistic regression was used to determine fall-associated risk factors and develop a fall prediction model. A nomogram was then plotted. The model performance was evaluated using the area under the curve (AUC), concordance index (C-index), and calibration curve. All analyses were performed using SPSS and R statistical packages.</p></sec><sec><title>Results</title><p>The prevalence of <italic>CF</italic> and falls were 1.4 and 19.4%, respectively. After adjusting for covariates, the odds ratio of <italic>CF</italic>, frailty only, and CoI only for falls were 2.27 (95% CI: 1.29–3.97), 1.41 (95% CI: 1.16–1.73), and 0.99 (95% CI: 0.43–2.29), respectively. <italic>CF</italic>, sex, age, hearing difficulty, depression, anxiety, disability in instrumental activities of daily living, and serious illness in the past 2 years were independently associated with falls. A prediction model based on these factors yielded an AUC of 0.646 and a C-index of 0.641.</p></sec><sec><title>Conclusion</title><p>Cognitive frailty (<italic>CF</italic>) exerted a cumulative effect on falls than did CoI or frailty alone. Joint assessments of cognitive function and frailty status may be beneficial for fall risk screening in community. A prediction model using <italic>CF</italic> as a factor could be helpful for this process.</p></sec>