This study aimed to investigate the association between global cognitive functioning (GCF) and fear of falling (FOF) in a large population-based sample of adults aged 45 years and older. A total of 2997 and 2012 participants from the original sample were included in the cross-sectional and prospective models, respectively. Participants were re-coded to 'no FOF' and 'FOF' based on their self-reported responses, and those who reported FOF at follow-up were defined as the newly-developed FOF group. GCF was evaluated at baseline and follow-up (2006 and 2020) using the Korean Mini-Mental State Examination (K-MMSE). Multivariable logistic regression models were used to examine the association between GCF at baseline and risk of FOF. In our study, 23.6% (706/2997) of the participants reported FOF at baseline, and 80.3% (1615/2012) reported newly-developed FOF in the follow-up cohort. Importantly, the negative association between GCF and FOF was observed not only in the cross-sectional analyses (odds ratio [OR] 0.97, 95% confidence interval [CI] 0.96-0.99) but also in the prospective analyses (OR 0.93, 95% CI 0.87-0.99). Furthermore, GCF was associated with lower odds of recurrent newly-developed FOF in the stable group than in the original sample (OR 0.87, 95% CI 0.78-0.97 vs OR 0.92, 95% CI 0.86-0.98). Thus, GCF was negatively associated with FOF at baseline and newly-developed FOF in the long-term follow-up cohort, and persistent deficits in GCF may increase the risk of newly-developed FOF. Further research should explore the mechanisms underlying the longitudinal relationship between GCF and newly-developed FOF.
Keywords: Fear of falling; Global cognitive function; Mini-Mental state examination.
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