Do subjective memory complaints predict falls, fractures and healthcare utilization? A two-year prospective study based on a cohort of older women recruited from primary care

Objective: A substantial proportion of older individuals report subjective memory complaints (SMC), which are thought to predict the development of cognitive impairment and dementia. Previous studies based in secondary care suggest that SMC is also associated with a number of other adverse health consequences including falls, fractures and increased healthcare utilisation. In this study, we aimed to establish whether similar findings are observed in the wider population.

Methods: Prospective analysis of the Cohort for Skeletal Health in Bristol and Avon (COSHIBA), a population based cohort recruited from primary care. Data were collected by self-completion questionnaire at baseline and two years. SMC was assessed at baseline. Fractures, measures of falls and mobility and healthcare utilisation were assessed two years later. A random 5% subsample of data were validated against GP records. Logistic regression was used to identify independent associations, following adjustment for a range of confounders assessed at baseline.

Results: Data were available on 3184 women. Three hundred and fifty participant (11.0%) reported SMC. They were older (73.3±4.5 vs 72.0±4.2 years) and less mobile compared to those not reporting SMC. SMCs at baseline were associated with an increased risk of upper limb fractures over the following 2 years (OR 1.72, 95%CI 1.02-2.90). SMCs were also associated with an increased risk of falls (OR 1.83, 95%CI 1.41-2.38) and increased healthcare utilisation (OR for hospital appointments 2.20, 95%CI 1.26-3.86). No association was observed with bone mineral density (BMD) at any site.

Conclusions: SMCs are important markers of adverse health outcomes and should prompt interventions to reduce fractures such as physiotherapy-led falls reduction programmes.