OBJECTIVES Fear of falling (FOF) is common in older adults. We investigated whether FOF affects development of cognitive decline over a 3-year period in community-dwelling older adults with intact cognition. DESIGN Retrospective, cohort, observational. SETTING AND PARTICIPANTS Data for 4280 older adults with normal cognition at baseline from the Survey of Living Conditions and Welfare Needs of Korean Older Persons (2008 and 2011). METHODS History of falls and severity of FOF (no fear, somewhat fearful, or very fearful) were assessed at baseline (2008). We evaluated cognitive function using the Korean version of the Mini-Mental State Examination in 2008 and 2011, and defined cognitive decline as a decrease of ≥3 points over the 3-year study period. Multivariable logistic regression analysis was performed to examine the association between FOF and cognitive decline. RESULTS The prevalence of being somewhat fearful of falling was 54.6% and that of being very fearful was 9.7%. The participants who were somewhat fearful of falling had a 1.2-fold higher risk of cognitive decline; this finding lost significance in adjusted models. The participants who were very fearful of falling had a 1.45-fold higher risk of cognitive decline than those with no FOF after adjusting for confounders [odds ratio (OR) 1.45, 95% confidence interval (CI) 1.08-1.95]. When we divided the participants according to age, sex, and baseline cognitive function, the association was significant in men (OR 2.29, 95% CI 1.24-4.25), participants age >70 years (OR 1.57, 95% CI 1.06-2.33), and those with a Mini-Mental State Examination score <30 (OR 1.45, 95% CI 1.07-1.98). CONCLUSIONS AND IMPLICATIONS Being very fearful of falling increased the risk of cognitive decline in older Korean adults. Physicians should be aware of the risk of development of cognitive impairment in older individuals with FOF.

中文翻译：

---

严重的跌倒恐惧与老年人的认知能力下降有关：一项为期 3 年的前瞻性研究

目标 跌倒恐惧 (FOF) 在老年人中很常见。我们调查了 FOF 是否会影响具有完整认知的社区老年人在 3 年内认知能力下降的发展。设计 回顾性、队列、观察性。设置和参与者 来自韩国老年人生活条件和福利需求调查（2008 年和 2011 年）的 4280 名在基线时认知正常的老年人的数据。方法 在基线（2008 年）评估跌倒史和 FOF 的严重程度（无恐惧、有些恐惧或非常恐惧）。我们在 2008 年和 2011 年使用韩版简易精神状态检查表评估了认知功能，并将认知下降定义为 3 年研究期间下降≥3 分。进行多变量逻辑回归分析以检查 FOF 与认知能力下降之间的关联。结果 有点害怕跌倒的发生率为54.6%，非常害怕的发生率为9.7%。有点害怕跌倒的参与者认知能力下降的风险高 1.2 倍；这一发现在调整后的模型中失去了意义。在调整混杂因素后，非常害怕跌倒的参与者认知能力下降的风险比没有 FOF 的参与者高 1.45 倍 [优势比 (OR) 1.45，95% 置信区间 (CI) 1.08-1.95]。当我们根据年龄、性别和基线认知功能对参与者进行划分时，男性 (OR 2.29, 95% CI 1.24-4.25)、年龄 >70 岁的参与者 (OR 1.57, 95% CI 1.06-2.33) 的相关性显着, 以及简易精神状态检查分数 <30 (OR 1.45, 95% CI 1.07-1.98) 的人。结论和意义 非常害怕跌倒会增加韩国老年人认知能力下降的风险。医生应该意识到患有 FOF 的老年人发生认知障碍的风险。