Modified STEADI Fall Risk Categories Predict Incident Cognitive Impairment

BACKGROUND/OBJECTIVES: It is unknown whether older adults at high risk of falls but without cognitive impairment have higher rates of subsequent cognitive impairment. DESIGN: This was an analysis of cross-sectional and longitudinal data from National Health and Aging Trends Study (NHATS). SETTING: NHATS, secondary analysis of data from 2011 to 2019. PARTICIPANTS: Community dwelling adults aged 65 and older without cognitive impairment. MEASUREMENTS: Participants were classified at baseline in three categories of fall risk (low, moderate, severe) using a modified algorithm from the Center for Disease Control's STEADI (Stop Elderly Accidents, Deaths, and Injuries) and fall risk from data from the longitudinal NHATS. Impaired global cognition was defined as NHATS-derived impairment in either the Alzheimer's Disease-8 score, immediate/delayed recall, orientation, clock-drawing test, or date/person recall. The primary outcome was the first incident of cognitive impairment in an 8 year follow-up period. Cox-proportional hazard models ascertained time to onset of cognitive impairment (referent = low modified STEADI incidence). RESULTS: Of the 7,146 participants (57.8% female), the median age category was 75 to 80 years. Prevalence of baseline fall modified STEADI risk categories in participants was low (51.6%), medium (38.5%), and high (9.9%). In our fully adjusted model, the risk of developing cognitive impairment was hazard ratio (HR) 1.18 [95% CI = 1.08, 1.29] in the moderate risk category, and HR 1.74 [95% CI = 1.53, 1.98] in the high-risk category. CONCLUSION: Older, cognitively intact adults at high fall risk at baseline had nearly twice the risk of cognitive decline at 8 year follow-up.



Work Title Modified STEADI Fall Risk Categories Predict Incident Cognitive Impairment
Open Access
  1. Rebecca S. Crow
  2. Christian Haudenschild
  3. Matthew C. Lohman
  4. Robert M. Roth
  5. Meredith Roderka
  6. Travis Masterson
  7. John Brand
  8. Tyler Gooding
  9. Todd A. Mackenzie
  10. John A. Batsis
License In Copyright (Rights Reserved)
Work Type Article
  1. Journal of the American Geriatrics Society
Publication Date May 1, 2021
Publisher Identifier (DOI)
Deposited November 17, 2021




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Work History

Version 1

  • Created
  • Added STEADIfall.pdf
  • Added Creator Rebecca S. Crow
  • Added Creator Christian Haudenschild
  • Added Creator Matthew C. Lohman
  • Added Creator Robert M. Roth
  • Added Creator Meredith Roderka
  • Added Creator Travis Masterson
  • Added Creator John Brand
  • Added Creator Tyler Gooding
  • Added Creator Todd A. Mackenzie
  • Added Creator John A. Batsis
  • Published
  • Updated
  • Updated