Gait, cognition and falls over 5 years, and motoric cognitive risk in New Zealand octogenarians: Te Puāwaitanga o Nga Tapuwae Kia Ora Tonu, LiLACS NZ.
Journal
BMC geriatrics
ISSN: 1471-2318
Titre abrégé: BMC Geriatr
Pays: England
ID NLM: 100968548
Informations de publication
Date de publication:
05 02 2020
05 02 2020
Historique:
received:
24
10
2019
accepted:
08
01
2020
entrez:
7
2
2020
pubmed:
7
2
2020
medline:
11
11
2020
Statut:
epublish
Résumé
Understanding falls risk in advanced age is critical with people over 80 a rapidly growing demographic. Slow gait and cognitive complaint are established risk factors and together comprise the Motoric Cognitive Risk Syndrome (MCR). This study examined trajectories of gait and cognition and their association with falls over 5 years, and documented MCR in Māori and non-Māori of advanced age living in New Zealand. Falls frequency was ascertained retrospectively at annual assessments. 3 m gait speed was measured and cognition was assessed using the Modified Mini-Mental Status Examination (3MS). Frequency of MCR was reported. Gait and cognition trajectories were modelled and clusters identified from Latent Class Analysis. Generalised linear models examined association between changes in gait, cognition, MCR and falls. At baseline, 138 of 408 Māori (34%) and 205 of 512 non-Māori (40%) had fallen. Mean (SD) gait speed (m/s) for Māori was 0.66 (0.29) and 0.82 (0.26) for non-Māori. Respective 3MS scores were 86.2 (15.6) and 91.6 (10.4). Ten (4.3%) Maori participants met MCR criteria, compared with 7 (1.9%) non-Māori participants. Māori men were more likely to fall (OR 1.56; 95% CI 1.0-2.43 (P = 0.04) whilst for non-Māori slow gait increased falls risk (OR 0.40; 95% CI 0.24-0.68(P < 0.001). Non-Māori with MCR were more than twice as likely to fall than those without MCR (OR 2.45; 95% CI 1.06-5.68 (P = 0.03). Māori and non-Māori of advanced age show a mostly stable pattern of gait and cognition over time. Risk factors for falls differ for Māori, and do not include gait and cognition.
Sections du résumé
BACKGROUND
Understanding falls risk in advanced age is critical with people over 80 a rapidly growing demographic. Slow gait and cognitive complaint are established risk factors and together comprise the Motoric Cognitive Risk Syndrome (MCR). This study examined trajectories of gait and cognition and their association with falls over 5 years, and documented MCR in Māori and non-Māori of advanced age living in New Zealand.
METHOD
Falls frequency was ascertained retrospectively at annual assessments. 3 m gait speed was measured and cognition was assessed using the Modified Mini-Mental Status Examination (3MS). Frequency of MCR was reported. Gait and cognition trajectories were modelled and clusters identified from Latent Class Analysis. Generalised linear models examined association between changes in gait, cognition, MCR and falls.
RESULTS
At baseline, 138 of 408 Māori (34%) and 205 of 512 non-Māori (40%) had fallen. Mean (SD) gait speed (m/s) for Māori was 0.66 (0.29) and 0.82 (0.26) for non-Māori. Respective 3MS scores were 86.2 (15.6) and 91.6 (10.4). Ten (4.3%) Maori participants met MCR criteria, compared with 7 (1.9%) non-Māori participants. Māori men were more likely to fall (OR 1.56; 95% CI 1.0-2.43 (P = 0.04) whilst for non-Māori slow gait increased falls risk (OR 0.40; 95% CI 0.24-0.68(P < 0.001). Non-Māori with MCR were more than twice as likely to fall than those without MCR (OR 2.45; 95% CI 1.06-5.68 (P = 0.03).
CONCLUSIONS
Māori and non-Māori of advanced age show a mostly stable pattern of gait and cognition over time. Risk factors for falls differ for Māori, and do not include gait and cognition.
Identifiants
pubmed: 32024482
doi: 10.1186/s12877-020-1420-8
pii: 10.1186/s12877-020-1420-8
pmc: PMC7003444
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
43Subventions
Organisme : Health Research Council of New Zealand
ID : HRC09/ 068B
Pays : International
Références
J Gerontol A Biol Sci Med Sci. 2000 Apr;55(4):M221-31
pubmed: 10811152
West J Nurs Res. 2009 Nov;31(7):948-64
pubmed: 19520966
N Engl J Med. 1988 Dec 29;319(26):1701-7
pubmed: 3205267
Age Ageing. 2006 Sep;35 Suppl 2:ii37-ii41
pubmed: 16926202
J Am Geriatr Soc. 2005 Sep;53(9):1618-22
pubmed: 16137297
JAMA. 2011 Jan 5;305(1):50-8
pubmed: 21205966
N Z Med J. 2014 Jul 04;127(1397):13-29
pubmed: 24997698
J Am Geriatr Soc. 2012 Nov;60(11):2127-36
pubmed: 23110433
J Clin Psychiatry. 1987 Aug;48(8):314-8
pubmed: 3611032
PLoS One. 2012;7(6):e40297
pubmed: 22768271
BMC Geriatr. 2012 Jun 29;12:33
pubmed: 22747503
Inj Prev. 2016 Feb;22(1):3-18
pubmed: 26635210
J Alzheimers Dis. 2016 Jun 18;53(3):1043-52
pubmed: 27340851
Aust N Z J Public Health. 2013 Apr;37(2):124-31
pubmed: 23551470
Am J Epidemiol. 2015 Apr 1;181(7):521-31
pubmed: 25700887
J Gerontol A Biol Sci Med Sci. 2013 Apr;68(4):412-8
pubmed: 22987797
Eur J Neurol. 2019 Apr;26(4):651-659
pubmed: 30565793
J Clin Epidemiol. 1999 Jul;52(7):643-51
pubmed: 10391658
Cochrane Database Syst Rev. 2018 Jul 23;7:CD012221
pubmed: 30035305
J Clin Epidemiol. 2003 Jul;56(7):622-8
pubmed: 12921930
Neurology. 2014 Aug 19;83(8):718-26
pubmed: 25031288
Int J Epidemiol. 2015 Dec;44(6):1823-32
pubmed: 26082404
J Psychiatr Res. 1982-1983;17(1):37-49
pubmed: 7183759
BMJ. 2016 Apr 28;353:i1419
pubmed: 27125497
J Am Geriatr Soc. 2010 Aug;58(8):1512-8
pubmed: 20646103