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Objective <p>Many risk factors affect dementia and all-cause mortality. However, whether falls are a risk factor for dementia and all-cause mortality is unclear. The study examines the association of falls with the risk of dementia and all-cause mortality, and whether dementia mediates the association of falls with all-cause mortality.</p> Methods <p>Data were taken from the Japanese Gerontological Evaluation Study (JAGES) with a 9-year follow-up. Falls information was collected through a questionnaire and categorized into no falls, single and multiple falls. Dementia and all-cause mortality data were obtained from the long-term care insurance (LTCI) system. The Cox proportional hazard models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs), and causal mediation analysis (CMA) was used to assess the mediating effects of dementia.</p> Results <p>A total of 52,076 participants were included in the study. Compared to participants with no falls, participants with single and multiple falls had an increased risk of dementia (single fall, HRs = 1.18, 95% CIs 1.12–1.24; multiple falls, HRs = 1.66, 95% CIs 1.56–1.77) and all-cause mortality (single fall, HRs = 1.09, 95% CIs 1.04–1.15; multiple falls, HRs = 1.34, 95% CIs 1.26–1.43), and the risk increased with the number of falls (<i>P</i> for trend &lt; 0.01). In addition, dementia significantly mediated the association between falls and risk of all-cause mortality (NIE: HRs = 1.02, 95% CIs 1.00–1.04, PM = 15.0%).</p> Conclusion <p>Falls are associated with the risk of dementia and all-cause mortality. Dementia has important mediating effects in the association between falls and the risk of all-cause mortality.</p>

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Association of falls with risk of dementia and all-cause mortality: a cohort study of Japanese older adults with a 9-year follow-up

  • 期刊论文

  • 发表日期：

    2025年1月14日

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  • Xiangbin Zhong,
  • Keyang Liu,
  • Yao Yao,
  • Honglin Cai,
  • Baoqing Huang,
  • Xiaojing Yuan,
  • Kokoro Shirai,
  • Katsunori Kondo,
  • Liqi Guan,
  • Qiqing Chen,
  • Xinlei Wang,
  • Yuting Li

摘要

Objective

Many risk factors affect dementia and all-cause mortality. However, whether falls are a risk factor for dementia and all-cause mortality is unclear. The study examines the association of falls with the risk of dementia and all-cause mortality, and whether dementia mediates the association of falls with all-cause mortality.

Methods

Data were taken from the Japanese Gerontological Evaluation Study (JAGES) with a 9-year follow-up. Falls information was collected through a questionnaire and categorized into no falls, single and multiple falls. Dementia and all-cause mortality data were obtained from the long-term care insurance (LTCI) system. The Cox proportional hazard models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (95% CIs), and causal mediation analysis (CMA) was used to assess the mediating effects of dementia.

Results

A total of 52,076 participants were included in the study. Compared to participants with no falls, participants with single and multiple falls had an increased risk of dementia (single fall, HRs = 1.18, 95% CIs 1.12–1.24; multiple falls, HRs = 1.66, 95% CIs 1.56–1.77) and all-cause mortality (single fall, HRs = 1.09, 95% CIs 1.04–1.15; multiple falls, HRs = 1.34, 95% CIs 1.26–1.43), and the risk increased with the number of falls (P for trend < 0.01). In addition, dementia significantly mediated the association between falls and risk of all-cause mortality (NIE: HRs = 1.02, 95% CIs 1.00–1.04, PM = 15.0%).

Conclusion

Falls are associated with the risk of dementia and all-cause mortality. Dementia has important mediating effects in the association between falls and the risk of all-cause mortality.