Executive Control, Alerting, Updating, and Falls in Cognitively Healthy Older Adults.

Background: Cognitive impairment represents a risk factor for falls in older adults. However, cognition is a complex construct comprising several functional domains. The relationship between specific cognitive domain and falls in cognitively healthy older adults is unclear.

Objectives: This study aims to investigate the relationship between falls, attention, and executive function in older adults while considering the three components of attention (alerting, orienting, and executive control) and three components of executive function (updating, inhibition, and shifting).

Methods: Cognitively healthy older adults were recruited (n = 60 for fallers and n = 100 for non-fallers). The participants were assessed on the Attention Network Test (alerting, orienting, and executive control), running memory test (updating), Stroop test (inhibition), and digit switching test (shifting). Confounder-adjusted logistic models were used to examine the associations between falls and specific cognitive functions in cognitively healthy older adults.

Results: The results showed that falls were associated with alerting, executive control, and updating. These associations were not attenuated when adjusting for a series of covariates such as age, gender, education, balance, general health, and emotional status.

Conclusions: The results suggest that among cognitively healthy older adults, falls are related to three specific cognitive functions: alerting, executive control, and updating. Disentangling the mechanism and contribution of cognitive deficits in fall risk may provide insights for the development of prevention and rehabilitation strategies for falls in older adults.