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Cognitive Frailty is Associated with Fall-Related Fracture among Older People

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The journal of nutrition, health & aging

Abstract

Objective

Cognitive frailty refers to cognitive impairment and physical frailty. Both cognitive impairment and physical frailty include risks of falling. The purpose of the study is to examine cognitive frailty and falling with/without a fracture.

Design

Cross-sectional observation study.

Setting

General communities in Japan.

Participants

Data of 10,202 older adults aged ≥ 65 years were collected.

Measurements

Physical frailty was characterized as slow walking speed and/or muscle weakness. Assessment of cognitive function included word lists memory, attention, executive function, and processing speed. Cognitive impairment refers to one or more cognitive decline indicated by at least 1.5 standard deviations below the threshold after adjusting for age and education. We operationally defined cognitive frailty as having both cognitive impairment and physical frailty. Participants were interviewed about their falling, history of fall-related fractures, and several potentially confounding factors such as demographic characteristics.

Results

Multinomial logistic regression analysis revealed that functional decline in all groups, as compared to the robust group, was significantly associated with falling without fractures, after adjusting for the covariates; cognitive impairment group (P =.017), physical frailty group (P =.002), and cognitive frailty group (P <.001). Only the cognitive frailty group had a significant association with fall-related fracture after adjusting for the covariates (OR 1.92, 95% CI: 1.20–3.08, P =.007).

Conclusion

Cognitive frailty is associated with not only falling but also fall-related fractures. Cognitive frailty may have a greater risk for fall-related fractures than cognitive impairment or physical frailty alone. Future research should examine causal the relationship between fall-related fractures and cognitive frailty.

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Authors and Affiliations

  1. Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu City, Aichi Prefecture, 474-8511, Japan

    Kota Tsutsumimoto, T. Doi, R. Hotta, S. Nakakubo & K. Makino

  2. Japan Society for the Promotion of Science, 5-3-1, Tokyo, Japan

    Kota Tsutsumimoto

  3. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Kota Tsutsumimoto

  4. Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan

    H. Makizako & H. Shimada

  5. Department of Physical Therapy, School of Health Sciences, Kagoshima University, Kagoshima, Japan

    H. Makizako

  6. National Center for Geriatrics and Gerontology, Aichi, Japan

    T. Suzuki

  7. Institute for Gerontology, J.F. Oberlin University, Tokyo, Japan

    T. Suzuki

Authors
  1. Kota Tsutsumimoto
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  2. T. Doi
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  3. H. Makizako
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  7. T. Suzuki
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  8. H. Shimada
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Correspondence to Kota Tsutsumimoto.

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Tsutsumimoto, K., Doi, T., Makizako, H. et al. Cognitive Frailty is Associated with Fall-Related Fracture among Older People. J Nutr Health Aging 22, 1216–1220 (2018). https://doi.org/10.1007/s12603-018-1131-4

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  • DOI: https://doi.org/10.1007/s12603-018-1131-4

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