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Association between falls and dementia risk: Evidence from three cohort studies
Aonan Li, Shaojiong Zhou, Jie Chang, Tao Wei, Bo Zhao, Yiwei Zhao, Zhibin Wang, Yi Xing et al.. Journal of Translational Internal Medicine, 2025-12-01
Topic: Risk, prevention and care in population studies
Abstract Background and Objectives The relationship between falls and dementia risk remains unclear. This study aims to investigate this association and assess the impact of genetic risk on this relationship. Methods We included 265,416, 5,506, and 948 participants from the United Kingdom (UK) Biobank, China Health and Retirement Longitudinal Study (CHARLS), and Xuanwu cognitive cohort. A Cox model and logistic regression analysis were used to estimate the relationship between falls and dementia risk. Results Falls showed significant associations with an elevated risk of dementia in both UK Biobank (single falls: Hazard Ratio [HR] 1.22, 95% Confidence Interval [CI]: 1.13-1.31; multiple falls: HR 1.73, 95% CI: 1.58-1.89), CHARLS cohorts (falls: HR 1.29, 95% CI: 1.11-1.50) and Xuanwu cognitive cohort (single falls: OR 1.72, 95% CI: 1.18-2.50; multiple falls: OR 1.89, 95% CI: 1.17-3.02). In addition, the results showed that falls were associated with cognitive decline during follow-up. Those who experienced single falls demonstrated reduced whole-brain gray matter volume (β = −1276.031, P = 0.029) and parahippocampal gyrus volume (β left = −22.410, P = 0.011; β right = −31.570, P = 0.001), whereas those experienced multiple falls, in addition to these findings, demonstrated increased deep white matter hyperintensities (β = 123.146, P = 0.004) and decreased gray matter volume in the hippocampus (β left = −18.440, P = 0.002; β right = −20.599, P = 0.001) and parahippocampal gyrus volume (β left = −48.805, P < 0.001; β right = −58.263, P < 0.001). Furthermore, falls and polygenic risk scores (PRSs) showed a significant interaction ( P = 0.001), with higher dementia risk observed in individuals with multiple falls and high genetic risk. Conclusions Falls are an early sign of dementia risk, and genetic susceptibility facilitates this association. Falls indicate potential atrophy in cognition-related brain regions. Falls are a simple and easily observable sign for dementia screening.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Li, A., Zhou, S., Chang, J., Wei, T., Zhao, B., Zhao, Y., et al. (2025). Association between falls and dementia risk: Evidence from three cohort studies. Journal of Translational Internal Medicine. https://doi.org/10.1515/jtim-2025-0057
Vancouver
Li A, Zhou S, Chang J, Wei T, Zhao B, Zhao Y, et al. Association between falls and dementia risk: Evidence from three cohort studies. Journal of Translational Internal Medicine. 2025. doi:10.1515/jtim-2025-0057. PMID: 41438467.
BibTeX
@article{li2025-41438467,
author = {Li, Aonan and Zhou, Shaojiong and Chang, Jie and Wei, Tao and Zhao, Bo and Zhao, Yiwei and Wang, Zhibin and Xing, Yi and others},
title = {{Association between falls and dementia risk: Evidence from three cohort studies}},
journal = {Journal of Translational Internal Medicine},
year = {2025},
doi = {10.1515/jtim-2025-0057},
pmid = {41438467},
url = {https://doi.org/10.1515/jtim-2025-0057}
}
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Key findings
- Results Falls showed significant associations with an elevated risk of dementia in both UK Biobank (single falls: Hazard Ratio [HR] 1.22, 95% Confidence Interval [CI]: 1.13-1.31; multiple falls: HR 1.73, 95% CI: 1.58-1.89), CHARLS cohorts (falls: HR 1.29, 95% CI: 1.11-1.50) and Xuanwu cognitive cohort (single falls: OR 1.72, 95% CI: 1.18-2.50; multiple falls: OR 1.89, 95% CI: 1.17-3.02).
- In addition, the results showed that falls were associated with cognitive decline during follow-up.
- Those who experienced single falls demonstrated reduced whole-brain gray matter volume (β = −1276.031, P = 0.029) and parahippocampal gyrus volume (β left = −22.410, P = 0.011; β right = −31.570, P = 0.001), whereas those experienced multiple falls, in addition to these findings, demonstrated increased deep white matter hyperintensities (β = 123.146, P = 0.004) and decreased gray matter volume in the hippocampus (β left = −18.440, P = 0.002; β right = −20.599, P = 0.001) and parahippocampal gyrus volume (β left = −48.805, P < 0.001; β right = −58.263, P < 0.001).
- Furthermore, falls and polygenic risk scores (PRSs) showed a significant interaction ( P = 0.001), with higher dementia risk observed in individuals with multiple falls and high genetic risk.
Why it matters
Falls were associated with a higher risk of dementia and cognitive decline in three separate cohorts, and with changes in brain structure. This suggests that falls may be an early sign of dementia risk, but the study does not show that preventing falls prevents dementia.
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Study details
- Study designlongitudinal study
- Participants265,416
- Effect sizeHR 1.73; HR 1.29; OR 1.72
- Evidence strengthModerate
How this study scored 53/100
Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Translational Internal Medicine) |
| Journal's citation record | 0 / 4 | Journal of Translational Internal Medicine: journal h-index 44 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 4 / 4 | 265,416 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 4 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 2.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Yi Tang: h-index 35 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Capital Medical University: institution h-index 643 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41438467) |
| Free to read | 2 / 2 | Free to read |
| Total | 53 / 100 | — |
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Read the original
- DOI: 10.1515/jtim-2025-0057
- PubMed: 41438467
- Original source →
- Free full text: Journal of Translational Internal Medicine →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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