Fall Prevention in Mild Cognitive Impairment

Falls represent the leading cause of hospitalization, nursing home admissions, disability and mortality for older adults with annual healthcare costs over $50 billion. Older Veterans with cognitive impairment are at an increased risk of falls and injurious fall. This pilot aims to determine the feasibility and effectiveness of a virtual neurorehabilitation intervention to improve functional mobility, strength, cognition and performance of activities of daily living in a cohort of 28 older Veterans with cognitive impairment. The overall goals are to improve fall risk in a population for which traditional rehabilitation programs may not be feasible. The investigators envision a neurorehabilitation model that can be readily exportable and widely implemented at other VA facilities with minimal resources as an enhancement to clinical care for fall prevention.

Inclusion criteria

• community dwelling
• at risk for falls as indicated by answering yes to one of the following: 1) have you fallen in the last year? 2) four square step test time > 15 seconds 3) are you worried about falling?
• cognitive impairment as indicated by either 1) clinical diagnosis 2) MOCA score of 10-25
• able to provide written consent

Exclusion criteria

• MOCA <10 or clinically diagnosed dementia
• inability to participate in a virtual intervention
• serious visual or hearing problems
• stroke with hemiparesis or severe neurological disease
• current use of medications affecting mental state
• current active participation in programs related to balance or mobility