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dc.contributor.authorMirelman, Anat
dc.contributor.authorHerman, Talia Nunes
dc.contributor.authorBrozgol, Marina
dc.contributor.authorDorfman, Moran
dc.contributor.authorSprecher, Elliot
dc.contributor.authorSchweiger, Avraham
dc.contributor.authorGiladi, Nir
dc.contributor.authorHausdorff, Jeffrey M.
dc.date.accessioned2013-03-18T19:28:30Z
dc.date.issued2012
dc.identifier.citationMirelman, Anat, Talia Herman, Marina Brozgol, Moran Dorfman, Elliot Sprecher, Avraham Schweiger, Nir Giladi, and Jeffrey M. Hausdorff. 2012. Executive function and falls in older adults: new findings from a five-year prospective study link fall risk to cognition. PLoS ONE 7(6): e40297.en_US
dc.identifier.issn1932-6203en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:10436333
dc.description.abstractBackground: Recent findings suggest that executive function (EF) plays a critical role in the regulation of gait in older adults, especially under complex and challenging conditions, and that EF deficits may, therefore, contribute to fall risk. The objective of this study was to evaluate if reduced EF is a risk factor for future falls over the course of 5 years of follow-up. Secondary objectives were to assess whether single and dual task walking abilities, an alternative window into EF, were associated with fall risk. Methodology/Main Results We longitudinally followed 256 community-living older adults (age: 76.4±4.5 yrs; 61% women) who were dementia free and had good mobility upon entrance into the study. At baseline, a computerized cognitive battery generated an index of EF, attention, a closely related construct, and other cognitive domains. Gait was assessed during single and dual task conditions. Falls data were collected prospectively using monthly calendars. Negative binomial regression quantified risk ratios (RR). After adjusting for age, gender and the number of falls in the year prior to the study, only the EF index (RR: .85; CI: .74–.98, p = .021), the attention index (RR: .84; CI: .75–.94, p = .002) and dual tasking gait variability (RR: 1.11; CI: 1.01–1.23; p = .027) were associated with future fall risk. Other cognitive function measures were not related to falls. Survival analyses indicated that subjects with the lowest EF scores were more likely to fall sooner and more likely to experience multiple falls during the 66 months of follow-up (p<0.02). Conclusions/Significance: These findings demonstrate that among community-living older adults, the risk of future falls was predicted by performance on EF and attention tests conducted 5 years earlier. The present results link falls among older adults to cognition, indicating that screening EF will likely enhance fall risk assessment, and that treatment of EF may reduce fall risk.en_US
dc.language.isoen_USen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.isversionofdoi:10.1371/journal.pone.0040297en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3386974/pdf/en_US
dash.licenseLAA
dc.subjectBiologyen_US
dc.subjectAnatomy and Physiologyen_US
dc.subjectMusculoskeletal Systemen_US
dc.subjectBiomechanicsen_US
dc.subjectNeuroscienceen_US
dc.subjectEngineeringen_US
dc.subjectBioengineeringen_US
dc.subjectBiomedical Engineeringen_US
dc.subjectMedicineen_US
dc.subjectPhysiological Processesen_US
dc.subjectAgingen_US
dc.subjectGeriatricsen_US
dc.subjectRehabilitationen_US
dc.subjectNeurologyen_US
dc.subjectCognitive Neurologyen_US
dc.subjectMovement Disordersen_US
dc.subjectPhysiotherapy and Rehabilitationen_US
dc.titleExecutive Function and Falls in Older Adults: New Findings from a Five-Year Prospective Study Link Fall Risk to Cognitionen_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalPLoS ONEen_US
dash.depositing.authorHerman, Talia Nunes
dc.date.available2013-03-18T19:28:30Z
dc.identifier.doi10.1371/journal.pone.0040297*
dash.contributor.affiliatedHausdorff, Jeffrey M
dash.contributor.affiliatedHerman, Talia Nunes


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