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Better executive function predicts less mobility decline after a fall

Executive function is the cognitive process that helps with planning, prioritizing, multitasking, and adjusting. Past studies suggest that better cognitive function is associated with better mobility as people age, yet little was known about its impact on mobility changes after a fall. A recent NIA-supported study found that the better one’s executive function, the less decline in mobility after a fall, and that measuring executive function may help predict change in mobility before a fall happens. This is especially important for older, inactive, and thinner adults. The work was presented at the Gerontological Society of America annual meeting in 2018 and recently published in Experimental Gerontology.

Older woman sitting at a dining table, smiling and playing cards.Researchers from Youngstown State University, University of Pennsylvania, and University of Pittsburgh studied 1,982 older adults from the Monongahela-Youghiogheny Healthy Aging Team study, a population-based study to examine the evolution of mild cognitive impairment in older adults supported in part by NIA. The participants were age 65 or older, not in long-term care, and able to attend a baseline assessment plus annual assessments for up to nine years. During these visits, participants reported how many times they had fallen during the year and researchers measured the participants’ mobility, cognition, and other factors of age-related mobility changes. This enabled the researchers to explore the relationship between cognitive processes and changes in mobility.

Each participant had a baseline mobility test that checked balance and walking ability. Of the 598 adults (average age 79) who had a fall, cognition scores from the pre-fall assessment were compared to the difference in mobility test performance between the pre- and post-fall year. The analysis found better executive function to be strongly associated with less decline in mobility performance. This was even more significant for those who were older, sedentary, and thinner, and was not seen among the 442 adults (average age 76) who did not fall during the study.

Results of this study suggest that executive function plays an important role in mobility after a fall, predictions of mobility decline after a fall, and brain networks involved in mobility control. However, the level to which executive function affects mobility, and whether this effect is through reduced decline or quicker recovery, is less clear because fall information was not detailed. Next steps include further studies exploring executive function — both as a way to measure risk of mobility changes after a fall and as a potential focus of cognitive training interventions to minimize or reduce declines in mobility after a fall.

This research was supported by NIA grants R01AG023651 and P30AG024827-11.

Reference: Hughes TF, et al. Executive function predicts decline in mobility after a fall: The MYHAT study. Experimental Gerontology. 2020;137:110948. doi: 10.1016/j.exger.2020.110948.