Is fear of falling associated with decline in global cognitive functioning in older adults: findings from the Irish longitudinal study on ageing

Background: Fear of falling (FoF) is present in 20% to 85% of older adults and may be an early marker of decline in global cognitive functioning (GCF). We tested the hypothesis that FoF is associated with lower levels of GCF (cross-sectional) and greater decline in GCF (prospective) in adults aged 50 and older. Design: Observational cohort study. Setting: The Irish Longitudinal Study on Ageing, a population-based study. Participants: Data were from 4931 participants (mean age 62.9 ± 9.1, range 50–98, 54.3% female). Measurements: FoF was based on self-report in 2010. GCF was measured with the Montreal Cognitive Assessment (MoCA) and Mini Mental Status Examination (MMSE) in 2010 and 2014. The cross-sectional association was examined using linear regression unadjusted and after adjustment for demographic and health factors. The prospective association between FoF and the odds of >1-SD decline in GCF were examined using logistic regression. Interaction with age and mediation by social and physical activities were examined. Results: In 2010, 21.9% of participants reported FoF. In the unadjusted cross-sectional models, those with FoF had lower scores on the MoCA (B −1.15, 95% confidence interval [CI] −1.40 to −0.90) and MMSE (B −0.52, CI −0.67 to −0.37). In the unadjusted prospective models, FoF was associated with a greater odds of decline in MoCA (odds ratio [OR] 1.60, CI 1.26–2.04) and MMSE (OR 1.64, CI 1.29–2.08). After adjustment for covariates, all associations attenuated and were no longer statistically significant, except the association with decline in MoCA (OR 1.32, CI 1.01–1.71). No statistically significant interaction with age was found (P >.37). Additional adjustment for social and physical activity did not change the results. Conclusions: The findings provide weak evidence for FoF as a predictor of cognitive decline