Falls and cognitive decline in Mexican Americans 75 years and older

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Abstract

Background: Little is known about long-term emotional and cognitive consequences of falls. We examined the association between falls and subsequent cognitive decline, and tested the hypothesis that depression would mediate any falls-cognition association among cognitively intact Hispanic Elders. Methods: We used data from the Hispanic Established Population for the Epidemiological Study of the Elderly to examine change in Mini Mental State Examination (MMSE) scores over the 6-year period according to number of falls. All participants (N=1,119) had MMSE scores ≥21 and complete data on Center for Epidemiologic Studies of Depression Scale, social and demographic factors, medical conditions (diabetes, heart attack, stroke, and hypertension), and hand grip muscle strength. Results: At baseline, participants' mean age was 80.8 years (range, 74-109), mean education was 6.3 years (range, 0-17), and mean MMSE was 25.2 (range, 21-30). Of the 1,119 participants, 15.8% experienced one fall and 14.4% had two or more falls. In mixed model analyses, having two or more falls was associated with greater decline in MMSE score (estimate =-0.81, standard error =0.19, P<0.0001) compared to having no fall, after adjusting for age, sex, marital status, and education. The magnitude of the association decreased (estimate =-0.65, standard error =0.19, P=0.0007) when adjustment was made for high depressive symptoms, suggesting a possible mediating effect of depression on the falls-cognition association. Female sex, high level of education, and high performance in hand grip muscle strength were associated with a slower decline in MMSE scores. Conclusion: Having two or more falls was independently associated with steeper decline in cognition over 6 years, with a possible mediating effect of depression on the falls-cognition association.

Original languageEnglish (US)
Pages (from-to)719-726
Number of pages8
JournalClinical Interventions in Aging
Volume9
DOIs
StatePublished - Apr 22 2014

Fingerprint

Cognition
Depression
Muscle Strength
Hand Strength
Education
Hispanic Americans
Epidemiologic Studies
Hand
Social Adjustment
Marital Status
Stroke
Myocardial Infarction
Demography
Cognitive Dysfunction
Hypertension
Population

Keywords

  • Cognition
  • Depression
  • Elderly

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Medicine(all)

Cite this

@article{9c75f648a5374f92a511945cc4bf6754,
title = "Falls and cognitive decline in Mexican Americans 75 years and older",
abstract = "Background: Little is known about long-term emotional and cognitive consequences of falls. We examined the association between falls and subsequent cognitive decline, and tested the hypothesis that depression would mediate any falls-cognition association among cognitively intact Hispanic Elders. Methods: We used data from the Hispanic Established Population for the Epidemiological Study of the Elderly to examine change in Mini Mental State Examination (MMSE) scores over the 6-year period according to number of falls. All participants (N=1,119) had MMSE scores ≥21 and complete data on Center for Epidemiologic Studies of Depression Scale, social and demographic factors, medical conditions (diabetes, heart attack, stroke, and hypertension), and hand grip muscle strength. Results: At baseline, participants' mean age was 80.8 years (range, 74-109), mean education was 6.3 years (range, 0-17), and mean MMSE was 25.2 (range, 21-30). Of the 1,119 participants, 15.8{\%} experienced one fall and 14.4{\%} had two or more falls. In mixed model analyses, having two or more falls was associated with greater decline in MMSE score (estimate =-0.81, standard error =0.19, P<0.0001) compared to having no fall, after adjusting for age, sex, marital status, and education. The magnitude of the association decreased (estimate =-0.65, standard error =0.19, P=0.0007) when adjustment was made for high depressive symptoms, suggesting a possible mediating effect of depression on the falls-cognition association. Female sex, high level of education, and high performance in hand grip muscle strength were associated with a slower decline in MMSE scores. Conclusion: Having two or more falls was independently associated with steeper decline in cognition over 6 years, with a possible mediating effect of depression on the falls-cognition association.",
keywords = "Cognition, Depression, Elderly",
author = "Anokha Padubidri and {Al Snih al snih}, Soham and {Samper Ternent}, Rafael and Kyriakos Markides and Kenneth Ottenbacher and Mukaila Raji",
year = "2014",
month = "4",
day = "22",
doi = "10.2147/CIA.S59448",
language = "English (US)",
volume = "9",
pages = "719--726",
journal = "Clinical Interventions in Aging",
issn = "1176-9092",
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T1 - Falls and cognitive decline in Mexican Americans 75 years and older

AU - Padubidri, Anokha

AU - Al Snih al snih, Soham

AU - Samper Ternent, Rafael

AU - Markides, Kyriakos

AU - Ottenbacher, Kenneth

AU - Raji, Mukaila

PY - 2014/4/22

Y1 - 2014/4/22

N2 - Background: Little is known about long-term emotional and cognitive consequences of falls. We examined the association between falls and subsequent cognitive decline, and tested the hypothesis that depression would mediate any falls-cognition association among cognitively intact Hispanic Elders. Methods: We used data from the Hispanic Established Population for the Epidemiological Study of the Elderly to examine change in Mini Mental State Examination (MMSE) scores over the 6-year period according to number of falls. All participants (N=1,119) had MMSE scores ≥21 and complete data on Center for Epidemiologic Studies of Depression Scale, social and demographic factors, medical conditions (diabetes, heart attack, stroke, and hypertension), and hand grip muscle strength. Results: At baseline, participants' mean age was 80.8 years (range, 74-109), mean education was 6.3 years (range, 0-17), and mean MMSE was 25.2 (range, 21-30). Of the 1,119 participants, 15.8% experienced one fall and 14.4% had two or more falls. In mixed model analyses, having two or more falls was associated with greater decline in MMSE score (estimate =-0.81, standard error =0.19, P<0.0001) compared to having no fall, after adjusting for age, sex, marital status, and education. The magnitude of the association decreased (estimate =-0.65, standard error =0.19, P=0.0007) when adjustment was made for high depressive symptoms, suggesting a possible mediating effect of depression on the falls-cognition association. Female sex, high level of education, and high performance in hand grip muscle strength were associated with a slower decline in MMSE scores. Conclusion: Having two or more falls was independently associated with steeper decline in cognition over 6 years, with a possible mediating effect of depression on the falls-cognition association.

AB - Background: Little is known about long-term emotional and cognitive consequences of falls. We examined the association between falls and subsequent cognitive decline, and tested the hypothesis that depression would mediate any falls-cognition association among cognitively intact Hispanic Elders. Methods: We used data from the Hispanic Established Population for the Epidemiological Study of the Elderly to examine change in Mini Mental State Examination (MMSE) scores over the 6-year period according to number of falls. All participants (N=1,119) had MMSE scores ≥21 and complete data on Center for Epidemiologic Studies of Depression Scale, social and demographic factors, medical conditions (diabetes, heart attack, stroke, and hypertension), and hand grip muscle strength. Results: At baseline, participants' mean age was 80.8 years (range, 74-109), mean education was 6.3 years (range, 0-17), and mean MMSE was 25.2 (range, 21-30). Of the 1,119 participants, 15.8% experienced one fall and 14.4% had two or more falls. In mixed model analyses, having two or more falls was associated with greater decline in MMSE score (estimate =-0.81, standard error =0.19, P<0.0001) compared to having no fall, after adjusting for age, sex, marital status, and education. The magnitude of the association decreased (estimate =-0.65, standard error =0.19, P=0.0007) when adjustment was made for high depressive symptoms, suggesting a possible mediating effect of depression on the falls-cognition association. Female sex, high level of education, and high performance in hand grip muscle strength were associated with a slower decline in MMSE scores. Conclusion: Having two or more falls was independently associated with steeper decline in cognition over 6 years, with a possible mediating effect of depression on the falls-cognition association.

KW - Cognition

KW - Depression

KW - Elderly

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