From the Emergency Department to Daily Life: A 12-Month Comparison of Fall Risk and Physical Function in Older Adults with and without Mild Cognitive Impairment
Bibliographic record
Abstract
INTRODUCTION: Older adults with mild cognitive impairment (MCI) are at elevated risk for falls and related complications. However, longitudinal data on fall incidence and functional recovery in high-risk individuals following a severe fall remain limited. This study aimed to compare 12-month fall incidence, cognitive and physical function, and physical activity in older adults with and without probable MCI who presented to the emergency department (ED) after a severe fall but were not hospitalized. METHODS: Data were collected from the SeFallED study, a prospective observational study of community-dwelling older adults (≥60 years) presenting to the ED due to a fall and discharged within 72 h of a fall. Participants were classified into older adults with and without probable MCI based on Montreal Cognitive Assessment scores (cut-off ≤24). Primary outcomes were recurrent falls and those demanding medical attention, assessed monthly via telephone interviews over 12 months. Secondary outcomes included cognitive performance, physical function (Short Physical Performance Battery, gait speed, postural sway), life-space mobility, and physical activity (accelerometry, self-report). RESULTS: Older adults with probable MCI (n = 116) were significantly more likely to experience a recurrent fall (52.6% vs. 36.5%; p = 0.012) and a fall requiring medical attention (33.6% vs. 11.9%; p < 0.001) than older adults without MCI (n = 126), as shown by chi-square tests. RM-ANCOVA indicated that cognitive performance improved in older adults with probable MCI over time, but no significant group differences emerged in physical function or physical activity. Life-space mobility remained consistently lower in older adults with probable MCI. CONCLUSION: Despite comparable physical function, older adults with probable MCI are at substantially higher risk of experiencing recurrent falls, including falls requiring medical attention. Further research should investigate whether incorporating a cognitive screening in the ED and initiating secondary falls prevention strategies at the earliest opportunity can reduce fall incidence, particularly among older adults with MCI.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".