Cognitive Impairment among Elderly Patients Presenting with Fall Injury in Orthopaedic Clinics in South Western Nigeria

Abstract

Background: Falls are a major cause of morbidity and mortality in the elderly and are associated with cognitive impairment. In this study, we described the association of mild cognitive impairment and dementia with number of falls among elderly patients presenting with fall injury in 2 hospitals in Southwestern Nigeria. Materials and Methods: This is a cross sectional descriptive study of seventy older adults presenting with fall injury at the Orthopaedic clinics in Ibadan, South Western Nigeria. Cognitive status of participants was assessed using Mini Mental State Examination (MMSE), Animal Fluency Test, Delayed Word Recall, Stick Design Test. Functioning was assessed by Instrumental Activity of Daily Living scale, severity of dementia by Clinical Dementia Rating scale (CDR). Results: The prevalence of dementia and mild cognitive impairment among the participants was 22.9% and 14.3% respectively. There was a linear correlation between number of falls and scores on the MMSE (r = -0.68) and CDR scale (r = 0.59) (P= .05). Participants with dementia were more likely to have more than one fall (OR: 3.74, CI: 1.14 -12.33). Those who had more than one fall in the previous 12 months had lower scores in all the neurocognitive test when compared to those with single fall. Conclusion: Since mild cognitive impairment and dementia were identified among these group of older adults and dementia was associated with multiple falls, attention to these problems could help reduce the risk of subsequent fall injury and possible morbidity and mortality.