Skip to main content

Subjective cognitive decline and fall risk in community-dwelling older adults with or without objective cognitive decline

Aging Clinical and Experimental Research volume 30, pages 457–462 (2018)Cite this article

Abstract

Background

The association between subjective cognitive decline and falls has not been clearly determined.

Aims

Our aim was to explore the effect of subjective cognitive decline on falls in community-dwelling older adults with or without objective cognitive decline.

Methods

We included 470 older adults (mean age 73.6 ± 5.2; 329 women) living in the community and obtained data on fall history directly from the participants. Subjective cognitive decline was assessed using a self-administered question. Objective cognitive function was measured using the Mini-Mental State Examination. Statistical analyses were carried out separately for participants with objective cognitive decline and those without.

Results

A multiple logistic regression analysis showed that, among participants without objective cognitive decline, subjective cognitive decline was positively associated with falls [OR 1.91; 95% confidence interval (CI) 1.17–3.12; p = 0.01). Conversely, among participants with objective cognitive decline, subjective cognitive decline was negatively associated with falls (OR 0.07; 95% CI 0.01–0.85, p = 0.04).

Discussion

The result suggests that the objective–subjective disparity may affect falls in community-dwelling older adults.

Conclusions

The presence of subjective cognitive decline was significantly positively associated with falls among cognitively intact older adults. However, among their cognitively impaired peers, the absence of subjective cognitive decline was positively associated with falls.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  1. Blake AJ, Morgan K, Bendall MJ et al (1998) Falls by elderly people at home: prevalence and associated factors. Age Ageing 17:365–372

    Article  Google Scholar 

  2. Peel NM, Kassulke DJ, McClure RJ (2002) Population based study of hospitalised fall related injuries in older people. Inj Prev 8:280–283

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  3. Murphy SL, Dubin JA, Gill TM (2003) The development of fear of falling among community-living older women: predisposing factors and subsequent fall events. J Gerontol Ser A Biol Sci Med Sci 58:M943–947

    Article  Google Scholar 

  4. Zijlstra GA, van Haastregt JC, van Eijk JT, van Rossum E, Stalenhoef PA, Kempen GI (2007) Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age Ageing 36:304–309

    CAS  Article  PubMed  Google Scholar 

  5. Cumming RG, Salkeld G, Thomas M, Szonyi G (2000) Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. J Gerontol Ser A Biol Sci Med Sci 55:M299–M305

    CAS  Article  Google Scholar 

  6. Friedman SM, Munoz B, West SK, Rubin GS, Fried LP (2002) Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc 50:1329–1335

    Article  PubMed  Google Scholar 

  7. Muir SW, Gopaul K, Montero-Odasso M (2012) The role of cognitive impairment in fall risk among older adults: a systematic review and meta-analysis. Age Ageing 41:299–308

    Article  PubMed  Google Scholar 

  8. Gleason CE, Gangnon RE, Fischer BL, Mahoney JE (2009) Increased risk for falling associated with subtle cognitive impairment: secondary analysis of a randomized clinical trial. Dement Geriatr Cogn Disord 27:557–563

    Article  PubMed  PubMed Central  Google Scholar 

  9. Uemura K, Shimada H, Makizako H, Doi T, Tsutsumimoto K, Lee S, Umegaki H, Kuzuya M, Suzuki T (2015) Effects of mild cognitive impairment on the development of fear of falling in older adults: a prospective cohort study. J Am Med Dir Assoc 16:1104.e9–1104.e13

    Article  Google Scholar 

  10. Tandetnik C, Farrell MT, Cary MS, Cines S, Emrani S, Karlawish J, Cosentino S (2015) Ascertaining subjective cognitive decline: a comparison of approaches and evidence for using an age-anchored reference group. J Alzheimers Dis 8:S43–S55

    Article  Google Scholar 

  11. Abdulrab K, Heun R (2008) Subjective memory impairment. A review of its definitions indicates the need for a comprehensive set of standardised and validated criteria. Eur Psychiatry 23:321–330

    Article  PubMed  Google Scholar 

  12. Dufouil C, Fuhrer R, Alpérovitch A (2005) Subjective cognitive complaints and cognitive decline: consequence or predictor? The epidemiology of vascular aging study. J Am Geriatr Soc 53:616–621

    Article  PubMed  Google Scholar 

  13. Reisberg B, Shulman MB, Torossian C, Leng L, Zhu W (2010) Outcome over seven years of healthy adults with and without subjective cognitive impairment. Alzheimer’s Dement 6:11–24

    Article  Google Scholar 

  14. Mitchell AJ, Beaumont H, Ferguson D, Yadegarfar M, Stubbs B (2014) Risk of dementia and mild cognitive impairment in older people with subjective memory complaints: meta-analysis. Acta Psychiatr Scand 6:1–13

    Google Scholar 

  15. Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E (1999) Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 56:303–308

    CAS  Article  PubMed  Google Scholar 

  16. Anstey KJ, von Sanden C, Luszcz MA (2006) An 8-year prospective study of the relationship between cognitive performance and falling in very old adults. J Am Geriatr Soc 54:1169–1176

    Article  PubMed  Google Scholar 

  17. Al-Sari UA, Tobias JH, Archer H, Clark EM (2016) Do subjective memory complaints predict falls, fractures and healthcare utilization? A two-year prospective study based on a cohort of older women recruited from primary care. Int J Geriatr Psychiatry. doi:10.1002/gps.4555

  18. Allison RK, Jasmine N, Erin SL, Kristine Y (2015) Memory complaints and risk of cognitive impairment after nearly 2 decades among older women. Neurology 85:1852–1858

    Article  Google Scholar 

  19. Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198

    CAS  Article  PubMed  Google Scholar 

  20. Lezak MD, Howieson DB, Loring DW (2004) Neuropsychological assessment, 4th edn. Oxford University Press, New York

    Google Scholar 

  21. Reelick MF, van Iersel MB, Kessels RP, Rikkert MG (2009) The influence of fear of falling on gait and balance in older people. Age Ageing 38:435–440

    Article  PubMed  Google Scholar 

  22. Joseph S, Alessia D, Julius P, Armin VG (2014) Subjective cognitive decline in patients with mild cognitive impairment and healthy older adults: association with personality traits. Geriatr Gerontol Int 14:589–595

    Article  Google Scholar 

  23. Segal ZV (1988) Appraisal of the self-schema construct in cognitive models of depression. Psychol Bull 103:147–162

    CAS  Article  PubMed  Google Scholar 

  24. Starkstein SE, Jorge R, Mizrahi R, Robinson RG (2006) A diagnostic formulation for anosognosia in Alzheimer’s disease. J Neurol Neurosurg Psychiatry 77:719–725

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  25. Wang L, van Belle G, Crane PK, Kukull WA, Bowen JD, McCormick WC, Larson EB (2004) Subjective memory deterioration and future dementia in people aged 65 and older. J Am Geriatr Soc 52:2045–2051

    Article  PubMed  Google Scholar 

  26. Geerlings MI, Jonker C, Bouter LM, Adèr HJ, Schmand B (1999) Association between memory complaints and incident Alzheimer’s disease in elderly people with normal baseline cognition. Am J Psychiatry 156:531–537

    CAS  PubMed  Google Scholar 

  27. Rabin LA, Smart CM, Crane PK et al (2015) Subjective cognitive decline in older adults: an overview of self-report measures used across 19 international research studies. J Alzheimers Dis 48:S63–S86

    Article  PubMed  PubMed Central  Google Scholar 

  28. Ganz DA, Higashi T, Rubenstein LZ (2005) Monitoring falls in cohort studies of community-dwelling older people: effect of the recall interval. J Am Geriatr Soc 53:2190–2194

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank the students of the Department of Human Health Sciences at Kyoto University for their help with the data collection.

Author information

Affiliations

  1. Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Hidehiko Shirooka, Naoto Fukutani, Yuto Tashiro, Yuma Nozaki & Tomoki Aoyama

  2. Tokyo Bay Rehabilitation Hospital, Chiba, Japan

    Hidehiko Shirooka

  3. Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, Tokyo, Japan

    Shu Nishiguchi

Authors
  1. Hidehiko Shirooka
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shu Nishiguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Naoto Fukutani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yuto Tashiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yuma Nozaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tomoki Aoyama
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hidehiko Shirooka.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the guidelines approved by the Kyoto University Graduate School of Medicine and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Shirooka, H., Nishiguchi, S., Fukutani, N. et al. Subjective cognitive decline and fall risk in community-dwelling older adults with or without objective cognitive decline. Aging Clin Exp Res 30, 457–462 (2018). https://doi.org/10.1007/s40520-017-0799-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40520-017-0799-3

Keywords

  • Subjective cognitive decline
  • Objective cognitive decline
  • Falls
  • Community-dwelling older adults