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The Influence of Cognitive Function on Balance, Mobility, and Falls in Older Cancer Survivors

Blackwood, Jennifer, PT, PhD1

doi: 10.1097/01.REO.0000000000000128

Introduction: Older cancer survivors fall more often, as disease-associated sequelae such as impaired cognitive function contribute to a higher falls risk. Cognitive dysfunction may contribute to falls and mobility; however, this relationship is not well described. The purpose of this study was to examine associations between cognitive function, gait speed, balance, and falls in older cancer survivors.

Methods: A cross-sectional analysis of 573 older cancer survivors was conducted from the 2010 Health and Retirement Study wave. Groups were assigned on the basis of falls history: Falls (N = 222) or No Falls (N = 351). Groupwise comparisons on demographic, cognitive, and physical mobility variables were completed. Linear regression analyses were performed to examine associations between cognitive function (recall, orientation, executive function), gait speed, tandem balance, and falls in the sample and by group.

Results: Significant between-group differences existed in demographic, cognitive function, falls, and mobility variables. Falls were inversely associated with executive function (β = −0.18, P < .05). Delayed recall was linearly associated with tandem stance in the whole sample (β = 0.11, P < .05). Falls history was able to detect differing relationships between gait speed and each of the cognitive processes (β = 0.11-0.17 for fallers; β = 0.11-0.22 for nonfallers), indicating the underlying influence of cognition on mobility in cancer survivors.

Discussion: Different cognitive processes influence falls, balance, and mobility in the older cancer survivor, especially those with a history of falling. Assessments of balance and falls should include screening more than orientation to detect cognitive impairments that impact mobility and falls.

1Board-Certified Geriatric Clinical Specialist, Physical Therapy Department, University of Michigan-Flint, Flint, MI

Correspondence: Jennifer Blackwood PT, PhD, Physical Therapy Department, University of Michigan-Flint, 2157 William S. White Bldg, 303 East Kearsley St, Flint, MI 48502 (

The author reports no declarations of interest.

Copyright 2018 © Oncology Section, APTA
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