050Is Fear of Falling Associated with Decline in Global Cognitive Functioning in Older Adults: Findings from the TILDA Study

Abstract

Background: Fear of falling (FoF) is present in 23% of Irish adults over 50 and may be an early marker of decline in cognitive functioning. However, previous studies examining the association between FoF and cognitive functioning were cross-sectional in design, included small samples and the measurement of cognitive functioning was limited to memory. We aimed to test the hypothesis that FoF is associated with decline in global cognitive functioning (GCF) in adults aged 50 and older. Method(s): Data were from 4960 participants (aged 50-98, 54.3% female) in The Irish Longitudinal Study on Ageing, a representative population-based observational study. FoF was based on self-report in 2010. GCF was measured with the MoCA and MMSE in 2010 to 2014. The cross-sectional association between FoF and GCF measured in 2010 was examined using linear regression. The prospective association between FoF measured in 2010 and the risk of >1 SD decline in GCF was examined using logistic regression. Models were run unadjusted and after adjustment for demographic and health factors. Interaction with age and mediation by social participation and physical activity were examined. Result(s): In 2010, the prevalence of FoF ranged from 15% in 50-55 year olds to 41% in 85+ year olds. In the unadjusted cross-sectional models, those with FoF had lower scores on the MoCA (B =-0.94, 95% confidence interval [CI] =-1.17;-0.70) and MMSE (B =-0.41, CI =-0.55;-0.27). In the unadjusted prospective models, FoF was associated with a greater risk of decline in MoCA (odds ratio [OR] = 1.51, CI = 1.21;1.89) and MMSE (OR = 1.47, CI = 1.18;1.83). However, all associations attenuated and were no longer statistically significant after adjustment for confounders. No statistically significant interaction with age was found (p > 0.26). Additional adjustment for social participation and physical activity did not change the results. Conclusion(s): The association between FoF and GCF is fully explained by demographic and health factors.