Trajectories of physical function, depressive symptoms, and cognitive performance before and after falls in older adults: A matched multicohort study
by Junjie Lin, Mika Kivimäki, Zifan Zhang, Hui Wang, Yangyang Cheng, Xiaolin Xu Background Impairments in physical, psychological, and cognitive functioning are associated with an increased risk of falls. However, how these functional domains change longitudinally before and after fall events remains unclear. We examined individual and joint trajectories of these outcomes preceding and following…
A study of older adults across three national cohorts in China, the UK, and the USA found that experiencing a fall was associated with poorer physical function, more severe depressive symptoms, and cognitive decline both before and after the fall event. These impairments were apparent up to 5 years prior to the fall and persisted afterward.
Participants who experienced falls showed a faster decline in physical function both before (β fall * pre-time −0.116) and after (β fall * post-time −0.039) the fall event. However, faster worsening of depressive symptoms was only observed prior to the fall event (β fall * pre-time −0.018), while cognitive performance decline was noted only afterward (β fall * post-time −0.008).
When analyzing joint trajectories, those who experienced falls were more likely to experience a progressive decline across all three domains, with a highest odds ratio of 2.45 for concurrent worsening in physical function, depression, and cognitive performance. The strongest associations were observed among participants who experienced more severe falls.
The study's limitations include reliance on self-reported falls, some functional measures, and an observational design, which did not allow for causal inference. The findings suggest that multidomain functional decline may precede falls by several years and worsen further after fall events, emphasizing the need for prevention and management strategies targeting physical, psychological, and cognitive domains in older adults.
Written by urgent.news from PLOS Medicine's reporting — not their text. Machine-written — it may contain errors, so check the original before relying on it.
