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Cognitive Impairment and Fall Risk

To retain quality of life and well-being, maintaining cognitive and physical functioning, as well as social connections, are all important. One of the concerns that many have about aging is the feared loss of cognitive abilities and increased memory problems. Although normal changes in cognitive functioning are experienced with age, these changes are usually not extensive enough to interfere with daily life and functioning, and people are able to find ways to accommodate the changes they experience.

However, some people experience more substantial changes in cognitive functioning and may have considerable difficulty with learning new things, concentrating, remembering, and/or making necessary decisions in everyday life. For these individuals, their cognitive functioning is impaired, as it negatively impacts their ability to successfully complete the activities of daily living, such as self-care and managing appointments, medications, finances, etc.

Preventative Risk Factors for Cognitive Impairment

Although there are various risk factors for cognitive impairment, some preventable risk factors include physical inactivity, depression, vitamin B12 deficiencies, high blood pressure and medication side effects. These modifiable risk factors highlight the interaction among physical health, mental health and cognitive functioning — all of which ultimately influence quality of life and well-being.

Although cognitive impairment impacts cognitive functioning in daily life and can influence mental health, physical health can also be impacted, for example, when medication instructions or a healthy lifestyle are not followed. A less well-known threat to physical health posed by cognitive impairment is fall risk.

Falls Are No. 1 Cause of Injuries in Seniors

Falls are the leading cause of unintentional fatal and nonfatal injuries in older adults. Approximately one in four older adults in America experiences a fall every year; this number is two to three times higher in those with cognitive impairment. Falls have the potential to cause short- or long-term consequences regardless of age; however, with increasing age, the possibility of a fall resulting in serious injury and the impact on future functioning and well-being is amplified, particularly in those with cognitive impairment.

Fall risk in older adults is higher when completing routine, everyday activities (e.g., house/yard work, running errands, etc.). Normal physical changes that occur in the body with age can be exacerbated by the loss of strength and balance, as well as the influence of chronic conditions (such as cognitive impairment) and/or medications, contributing to the increased risk of falls. For those with cognitive impairment, deficiencies in attention and executive functioning (such as the ability to plan, to switch back and forth between tasks, to ignore irrelevant information, etc.) have been identified as the most pertinent in regard to increased fall risk.

Understanding the potential risks and consequences of both cognitive impairment and falls is essential in order to take steps to promote quality of life and well-being. The Centers for Disease Control and Prevention has two ongoing initiatives relevant to maintaining cognitive functioning (Healthy Brain Initiative) and addressing fall risk (STEADI), which demonstrate the commitment to improving and preserving quality of life and well-being throughout older adulthood.

About the Author

Julie Blaskewicz Boron, Ph.D., is an Associate Professor and the Doctoral Program Chair of the Department of Gerontology, University of Nebraska at Omaha.

Julie Blaskewicz Boron
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