Two-year Longitudinal Relationships between Frailty, Cognitive Function, and Fall in Community-Dwelling Older Korean Adults

Abstract

Purpose Frailty and cognitive function are known factors associated with falls (Fhon et al., 2016; Kim, 2020; Robertson et al., 2014). The identification of preventable factors related to falls is a public health priority. This study aimed to determine the longitudinal relationships between frailty, cognitive function, and falls among community-dwelling older people. Method This study utilized data from the first (2016–2017) and second (2018–2019) waves of the Korean Frailty and Aging Cohort Study; 2318 people aged ≥70 years were included. Frailty was assessed with the Fried frailty index (Fried et al., 2001) and fall experience was classified into the presence or absence of a fall in the past year. Cognitive function was measured using the Mini-Mental State Examination (MMSE). Descriptive statistics and Pearson’s correlation coefficient were used to identify relationships among these variables. Results and Discussion Over time from Wave 1 to Wave 2, the participants’ frailty increased, cognitive function declined, and fall experience increased. A significant positive correlation existed between fall at Wave 1 and fall at Wave 2 (r=.180, p < 0.001); frailty at Wave 1 and fall at Wave 2 (r=.120, p < 0.001); MMSE at Wave 1 and fall at Wave 2 (r=-.069, p < 0.001; Table 1). The results showed that higher frailty level at Wave 1 was correlated with more fall experiences at Wave 2 and higher MMSE score at Wave 1 was correlated with absence of fall experiences at Wave 2. Healthcare providers should plan fall-prevention programs considering the improvement of physical frailty and improvement/maintenance of cognitive function. Targeting improvement of frailty is a feasible approach to reducing the burden of falls among older people, fall prevention is an effective method for preventing another possible fall among older adults in the future.

Table 1 Correlation between frailty, cognitive function, and fall at each wave (N=2318)

Variables

Frailty_W1

Frailty_W2

MMSE_W1

MMSE_W2

Fall_W1

Fall_W2

r (p)

r (p)

r (p)

r (p)

r (p)

r (p)

Frailty_W1

Frailty_W2

.516

(<.001)

MMSE_W1

-.289

(<.001)

-.272

(<.001)

MMSE_W2

-.294

(<.001)

-.283

(<.001)

.658

(<.001)

Fall_W1

.137

(<.001)

.113

(<.001)

-.053

(.011)

-.026

(.204)

Fall_W2

.120

(<.001)

.167

(<.001)

-.069

(.001)

-.040

(.055)

.180

(<.001)

Note: W1 (wave 1), W2 (wave 2)

MMSE=mini-mental state examination