American Journal of Epidemiology · Apr 30, 2025

Falls and subsequent cognitive function in older adults in England and the USA, 2010-2020: a population-based, cross-nationally harmonized, longitudinal study

By Kou W, Shi S, Huang J et al.

INTRODUCTION: The understanding of the long-term cognitive consequences of falls remains insufficient. Our research aims to explore the association between falls and both global and domain-specific cognitive decline, utilizing nationally representative aging cohorts. METHODS: We studied 13 652 individuals from the English Longitudinal Study of Aging (ELSA) and the Health and Retirement Study (HRS). Falls were assessed based on self-reported incidents, categorized as no falls, a single fall, and multiple falls. Global cognitive z scores were calculated based on memory (immediate and delayed recall tests), executive function (animal fluency, serial sevens, and counting-backward tests), and orientation (date orientation test). Linear mixed-effects models examined associations between falls and cognitive outcomes after adjusting for potential confounders. RESULTS: Individuals with a single fall (pooled β = -0.006; 95% CI, -0.012 to -0.001; P = 0.033) and those with multiple falls (pooled β = -0.021; 95% CI, -0.026 to -0.015; P < 0.001) experienced a faster decline in global cognitive z scores compared to those with no falls. Similar patterns were observed across memory, executive function, and orientation. DISCUSSION: In this combined cohort study, including samples from ELSA and HRS, we discerned a marked association between the falls and both global and domain-specific cognitive decline. This article is part of a Special Collection on Cross-National Gerontology.

doi.org/10.1093/aje/kwaf089Open accessPubMed 40302119Populations