BACKGROUND Evidence suggests that better cognitive functioning is associated with better mobility in older age. It is unknown whether older adults with better cognitive function are more resilient to mobility decline after a fall. METHODS Participants from the Monongahela Youghiogheny Healthy Aging Team (MYHAT) study were followed annually for up to 9 years for incident falls. We examined one-year (mean 1.0 year, SD 0.1) change in mobility pre- to post-fall using the Timed Up and Go (TUG) in relation to pre-fall cognition (executive function, attention, memory, and visuospatial function) among incident fallers (n = 598, mean age 79.1, SD = 7.0). Linear regression models tested the association of cognition with change in TUG. Interaction terms were tested to explore if age, sex, body mass index, physical activity, depressive symptoms, or visual acuity modified the associations of cognition and mobility among fallers. The association between cognition and one-year change in TUG was also tested in a comparison sample of non-fallers (n = 442, mean age 76.3, SD = 7.2). RESULTS Overall, mobility decline was greater in fallers compared to non-fallers. In fully-adjusted models, higher executive function, but not attention, memory, or visuospatial function, was associated with less decline in mobility among incident fallers. The effect was significantly stronger for those who were older, sedentary, and had lower body mass index. Higher scores in memory tests, but not in other domains, was associated with less mobility decline among non-fallers. CONCLUSIONS Higher executive function may offer resilience to mobility decline after a fall, especially among older adults with other risk factors for mobility decline. Future studies should assess whether executive function may be a helpful risk index of fall-related physical functional decline in geriatric settings.

中文翻译：

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执行功能预测跌倒后活动能力下降：MYHAT 研究。


背景证据表明，更好的认知功能与老年人更好的活动能力相关。目前尚不清楚认知功能较好的老年人是否更有能力应对跌倒后行动能力下降的情况。方法 每年对 Monongahela Youghiogheny 健康老龄化团队 (MYHAT) 研究的参与者进行长达 9 年的跌倒事件跟踪。我们使用定时起立 (TUG) 检查跌倒前与跌倒后一年（平均 1.0 年，SD 0.1）活动能力的变化与跌倒前认知（执行功能、注意力、记忆力和视觉空间功能）的关系跌倒事件发生者（n = 598，平均年龄 79.1，SD = 7.0）。线性回归模型测试了认知与 TUG 变化的关联。测试了交互项，以探讨年龄、性别、体重指数、体力活动、抑郁症状或视力是否改变了跌倒者认知和活动能力的关联。认知与 TUG 一年变化之间的关联也在非跌倒者的比较样本中进行了测试（n = 442，平均年龄 76.3，SD = 7.2）。结果 总体而言，与非跌倒者相比，跌倒者的活动能力下降幅度更大。在完全调整的模型中，较高的执行功能（而不是注意力、记忆力或视觉空间功能）与事故摔倒者活动能力下降较少相关。对于年龄较大、久坐和体重指数较低的人来说，这种效果明显更强。记忆测试中得分较高（但在其他领域则不然）与非跌倒者的活动能力下降较少相关。结论 高级执行功能可能会提供对跌倒后行动能力下降的恢复能力，特别是对于具有其他行动能力下降风险因素的老年人。 未来的研究应该评估执行功能是否可能是老年环境中与跌倒相关的身体功能下降的一个有用的风险指标。