Hidden Risks in Active Ageing: Executive Dysfunction, Polypharmacy, and Fall Risk in Senior University Students – A Cross-Sectional study
Abstract
Introduction: Participation in Senior University programs is often viewed as a proxy for active and healthy ageing. However, the prevalence of geriatric syndromes in this specific population—particularly fall risk associated with executive decline and polypharmacy burden—remains under-characterized. This study aimed to phenotype the fall risk profile by analyzing the interplay between physical, cognitive, and extrinsic determinants in a cohort of community-dwelling older adults in Southern Portugal.
Methods: A cross-sectional analytical study was conducted with community-dwelling individuals aged ≥65 years. The screening protocol included the collection of sociodemographic and clinical data (fall history, comorbidities, therapeutic profile) and a multidimensional functional assessment: fear of falling (Falls Efficacy Scale-International, FES-I), dual-task mobility (Timed Up and Go-Cognitive, TUGc) and executive function (Frontal Assessment Battery, FAB). Descriptive and inferential statistical analyses were performed to identify risk patterns.
Results: Sample comprised 128 participants with a mean age of 74.95 ± 6.13 years (95% CI: 74.17–75.81). 31.3 % reported falling in the previous year. Predominant comorbidities included hypertension (54.8%), osteoarthritis (31.0%), cardiac disease (20.5%), and anxiety/depression (28.0%). 41.4% of participants reported Polypharmacy (≥4 drugs). Functional markers revealed critical discrepancies: while only 19.5% presented high physical risk on the TUGc (≥13.5 s), a significantly higher proportion demonstrated neuropsychological vulnerability. Specifically, 28.8% and 45.2% exhibited moderate and marked executive dysfunction, respectively, and 98.6% expressed high fear of falling. A significant correlation was observed between executive dysfunction and higher levels of fear of falling.
Conclusions: Data reveal a "hidden" risk profile in socially active older adults: although independent in the community, they present a high burden of polypharmacy and executive dysfunction—factors that potentiate fall risk These findings suggest that prevention strategies in Senior Universities must integrate multicomponent strategies
This work was supported by FCT - Fundação para a Ciência e Tecnologia, I.P. by project reference"UID/05704/2025" and DOI identifierhttps://doi.org/10.54499/UID/05704/2025
Comments
Interesting
This is a really interesting study- thanks. I wonder if undertaking some assessment of vestibular performance within this group my also shed some further light into older adults functional restrictions. We often see older adults who struggle with dual tasking due to the cognitive load of maintaining balance due (at least in part) to vestibular dysfunction. Imbalance/unsteadiness is often, though incorrectly, viewed as a an unavoidable byproduct of ageing, which frequently prevents older adults accessing support.
Many thanks,
Ed Tank
Tanks
Thank you for your insightful comments. In fact, upon completing the study, we also reflected on the potential value of including vestibular function assessments. We agree that vestibular dysfunction is a significant contributor to balance impairment in older adults. This is an important area that was beyond the scope of the present study, but we intend to explore it in future research.