PA 15-3-1767 Mild cognitive impairment: a risk factor for injury in older people

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Abstract

Background

Mild cognitive impairment (MCI) is an intermediate state between normal cognitive ageing and dementia. Global estimates suggest 22% of adults>65 years have MCI. People with dementia have double the rate of injury-related hospitalisations and poorer health outcomes than those without. However, no previous research has explored whether people with MCI are also at increased risk of injury.

Objective

To describe the injury profile, hospitalisation rates, and health outcomes for people with MCI, and determine whether these differ from those with normal cognition and dementia.

Methods

Participants were 867 community-dwelling 70–90 year olds enrolled in the population-based longitudinal Sydney Memory and Ageing Study (MAS), who underwent comprehensive neuropsychological assessments at baseline, then 2, 4 and 6 years’ follow-up. Cognitive status was classified into normal, MCI and dementia at each assessment. MAS records were linked to hospital and death records to identify injury-related hospitalisations and outcomes for the 2 year period following each assessment.

Findings

There were 335 injury-related hospitalisations. After adjusting for age-and-sex, participants with MCI had 1.7 (95% CI 1.2–2.4) times higher odds of an injury-related hospitalisation than participants with normal cognition, whilst participants with dementia had 2.3 (95% CI 1.2 to 4.4) times higher odds. There was no difference in odds between participants with MCI and dementia.

Findings

Of the 116 hospitalisations for people with MCI, the majority (79.3%) were due to falls. Non-fracture head injuries (25.9%), upper limb and trunk fractures (13.8% respectively) were the most common injury type. There were no differences in injury type, mean length of stay, or 30 day mortality between people with normal cognition, MCI and dementia.

Conclusion and policy implications

Older people with objectively defined MCI are at higher risk of injury, predominantly as a result of falls, than their cognitively intact peers. Falls risk screening and fall prevention initiatives may be indicated for people with MCI.

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