TY - JOUR
T1 - Cognitive status is a determinant of health resource utilization among individuals with a history of falls
T2 - a 12-month prospective cohort study
AU - Davis, J. C.
AU - Dian, L.
AU - Khan, K. M.
AU - Bryan, S.
AU - Marra, C. A.
AU - Hsu, C. L.
AU - Jacova, P.
AU - Chiu, B. K.
AU - Liu-Ambrose, T.
N1 - Funding Information:
The Canadian Institute for Health Research Emerging Team Grant (CIHR, MOB-93373 to KMK, TLA, CAM) provided funding for this study.
Funding Information:
We thank the Vancouver Falls Prevention Cohort study participants. The Canadian Institute for Health Research Emerging Team Grant (CIHR, MOB-93373 to KMK, TLA, CAM) provided funding for this study. TLA is a Canada Research Chair in Physical Activity, Mobility, and Cognitive Neuroscience, a Michael Smith Foundation for Health Research (MSFHR) Scholar, a Canadian Institutes of Health Research (CIHR) New Investigator, and a Heart and Stroke Foundation of Canada’s Henry JM Barnett’s Scholarship recipient. JCD was funded by a CIHR and MSFHR Postdoctoral Fellowship. CLS is an Alzheimer’s Society Research Program Trainee. These funding agencies did not play a role in study design.
Publisher Copyright:
© 2015, International Osteoporosis Foundation and National Osteoporosis Foundation.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Summary: Falls are a costly public health problem worldwide. The literature is devoid of prospective data that identifies factors among fallers that significantly drive health care resource utilization. We found that cognitive function—specifically, executive functions—and cognitive status are significant determinants of health resource utilization among older fallers. Introduction: Although falls are costly, there are no prospective data examining factors among fallers that drive health care resource utilization. We identified key determinants of health resource utilization (HRU) at 6 and 12 months among older adults with a history of falls. Specifically, with the increasing recognition that cognitive impairment is associated with increased falls risk, we investigated cognition as a potential driver of health resource utilization. Methods: This 12-month prospective cohort study at the Vancouver Falls Prevention Clinic (n = 319) included participants with a history of at least one fall in the previous 12 months. Based on their cognitive status, participants were divided into two groups: (1) no mild cognitive impairment (MCI) and (2) MCI. We constructed two linear regression models with HRU at 6 and 12 months as the dependent variables for each model, respectively. Predictors relating to mobility, global cognition, executive functions, and cognitive status (MCI versus no MCI) were examined. Age, sex, comorbidities, depression status, and activities of daily living were included regardless of statistical significance. Results: Global cognition, comorbidities, working memory, and cognitive status (MCI versus no MCI ascertained using the Montreal Cognitive Assessment (MoCA)) were significant determinants of total HRU at 6 months. The number of medical comorbidities and global cognition were significant determinants of total HRU at 12 months. Conclusion: MCI status was a determinant of HRU at 6 months among older adults with a history of falls. As such, efforts to minimize health care resource use related to falls, it is important to tailor future interventions to be effective for people with MCI who fall. Trial registration: ClinicalTrials.gov Identifier: NCT01022866.
AB - Summary: Falls are a costly public health problem worldwide. The literature is devoid of prospective data that identifies factors among fallers that significantly drive health care resource utilization. We found that cognitive function—specifically, executive functions—and cognitive status are significant determinants of health resource utilization among older fallers. Introduction: Although falls are costly, there are no prospective data examining factors among fallers that drive health care resource utilization. We identified key determinants of health resource utilization (HRU) at 6 and 12 months among older adults with a history of falls. Specifically, with the increasing recognition that cognitive impairment is associated with increased falls risk, we investigated cognition as a potential driver of health resource utilization. Methods: This 12-month prospective cohort study at the Vancouver Falls Prevention Clinic (n = 319) included participants with a history of at least one fall in the previous 12 months. Based on their cognitive status, participants were divided into two groups: (1) no mild cognitive impairment (MCI) and (2) MCI. We constructed two linear regression models with HRU at 6 and 12 months as the dependent variables for each model, respectively. Predictors relating to mobility, global cognition, executive functions, and cognitive status (MCI versus no MCI) were examined. Age, sex, comorbidities, depression status, and activities of daily living were included regardless of statistical significance. Results: Global cognition, comorbidities, working memory, and cognitive status (MCI versus no MCI ascertained using the Montreal Cognitive Assessment (MoCA)) were significant determinants of total HRU at 6 months. The number of medical comorbidities and global cognition were significant determinants of total HRU at 12 months. Conclusion: MCI status was a determinant of HRU at 6 months among older adults with a history of falls. As such, efforts to minimize health care resource use related to falls, it is important to tailor future interventions to be effective for people with MCI who fall. Trial registration: ClinicalTrials.gov Identifier: NCT01022866.
KW - Cost
KW - Falls
KW - Health resource utilization
KW - Older adults
UR - http://www.scopus.com/inward/record.url?scp=84959087537&partnerID=8YFLogxK
U2 - 10.1007/s00198-015-3350-4
DO - 10.1007/s00198-015-3350-4
M3 - Journal article
C2 - 26449355
AN - SCOPUS:84959087537
SN - 0937-941X
VL - 27
SP - 943
EP - 951
JO - Osteoporosis International
JF - Osteoporosis International
IS - 3
ER -