The Relationship Between Specific Cognitive Function And Fall In The Elderly

Background: Falling is the social purpose of accidental injury and the production of traditionally important public health theories.At the same time,consciousness also includes several complex mental activities,and the relationship between cognitive function in a specific field and experience of falling is unclear.Objectives: This study aims to investigate the relationship between specific cognitive functions and falls in the elderly.Specific cognitive functions mainly consider the three components of attention(alerting,orientation,and executive control)and the three components of executive function(updating,inhibition,and shifting).Methods: The elderly with normal cognitive function aged 60 years and above were recruited in the community of Guangzhou.First,we collected basic information of the participants,such as age,gender,years of education,and annual family income,and at the same time conducted a comprehensive mental and clinical assessment of the participants,including using the Montreal Cognitive Scale(MOCA)to assess the overall status of cognitive function in the elderly.The Charlson Comorbidity Index(CCI)was used to evaluate the overall health status of the elderly,the Geriatric Depression Scale(GDS)was used to evaluate the mental status of the elderly,the Activities of Daily Living Scale(ADL)was used to evaluate the independent ability of the elderly,and the Balance Assessment System test was used to evaluate the balance ability of the elderly.In addition,we performed a series of neuropsychological assessments on participants,including the Attention Network Test(which assesses alertness,orientation,and executive control,respectively),the Operational Memory Test(which assesses renewal function),the Stroop Test(which assesses inhibition function),and the Digital Switching Test(which assesses transfer function).The elderly were divided into the fall group and the non-fall group according to whether they had fallen in the past year as the dependent variable.The relationship between falls and specific cognitive function was examined by confounding factor adjusted Logistic model.Results: The results showed that falls were associated with alerting,executive control,and updating.These associations were not attenuated when adjusting for a series of covariates such as age,gender,education,balance,general health,and emotional s tatus.A total of 159 subjects were included,including 59 subjects in the fall group(14 males,average age 67.19 ± 7.13 years old)and 100 subjects in the non-fall group(35 males,average age 67.76 ± 5.73 years old).There were no significant differences among MOCA score,Charlson comorbidity index,geriatric depression scale score and daily living ability score(P > 0.05).The findings:(1)To investigate the incidence of falls in older people in the group was 37%.(2)In the fall,by 78.3% to fall to the elderly body damage,fall in the 60% of the normal life for the elderly more than two days and need to treatment.(3)The influence of group compared with the fall,fall set the balance ability of low,alert effect executive control effect is larger,t he renewal effect is poorer.(4)After controlling confounding factors such as age and gender,the likelihood ratio forward method in multivariate logistic regression was used to fit the data,and the independent risk factors affecting falling in the elderly were screened and the OR value was estimated.The test level α= 0.05.The results showed that alerting in the attention network(OR = 1.024;95%CI: 1.008,1.040,P = 0.003),executive control(OR = 1.576;95%CI: 1.036,2.398,P = 0.034)were independent risk factors for fall in the elderly,updating in executive function(OR = 0.866,95%CI: 0.792,0.946,P < 0.001)was independent protective factors for fall in the elderly,while other factors had no statistically significant association with falls in the elderly.Conclusions: The fall of the elderly with normal cognitive function is related to alertness,executive control and renewal of executive function in the attention network.For people over 60 years of age,cognitive dysfunction should be considered as a risk factor for falls,and executive function and attention should be evaluated in routine fall risk assessments.This study describes and discusses the relationship between specific cognitive functions and fall risk from the perspective of neuropsychology,provides new insights for the study of the neural mechanism of falls,and further provides a basis for fall prevention and rehabilitation strategies for the elderly.