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J Geriatr Phys Ther. 2018 Jul 11. doi: 10.1519/JPT.0000000000000209. [Epub ahead of print]

Cognitive Function and Falls in Older Adults With Type 2 Diabetes Mellitus.

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Physical Therapy Department, University of Michigan-Flint.



Cognitive impairments have been reported in older adults with type 2 diabetes (T2DM), which subsequently increases the risk of falling. However, the relationship between specific cognitive processes and falls has not been reported. Therefore, the purpose of this study was to describe the contribution of cognitive function on falls in older adults with T2DM and to describe any differences by age group.


A cross-sectional analysis was conducted of 1171 older adult respondents with T2DM from the 2010 wave of the Health and Retirement Study. Group assignment was based on age: younger group 65 to 74 years (N = 662) or older group (N = 509). Groupwise comparisons on demographic, cognitive, and mobility variables were completed, followed by logistic regression analyses to examine the contribution of specific cognitive processes on falls for the sample and then by group after controlling for demographic and mobility-related variables.


Significant differences existed between groups in demographic, cognitive, and mobility variables and falls. Executive function was consistently identified as a predictor of falls in the whole sample (odds ratio [OR] = 1.06; 95% CI, 1.02-1.09) and within groups: younger group (OR = 1.06; 95% CI, 1.01-1.11) and older group (OR = 1.07; 95% CI, 1.01-1.13), while delayed recall was a much stronger predictor of falls in the older group (OR = 1.28; 95% CI, 1.03-1.59). Orientation and immediate recall were not predictors of falls.


Executive function and delayed recall, 2 cognitive domains reported to influence glycemic control and disease management in those with T2DM, are associated with an increased fall risk and should be included in the assessment of fall risk in this population.

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