Abstract INTRODUCTION: The understanding of the long-term cognitive consequences of falls remains insufficient. Our research aims to explore the association between falls and domain-specific cognitive decline, utilizing nationally representative aging cohorts. METHODS We studied 13,652 individuals from the English Longitudinal Study of Ageing (ELSA) and the Health and Retirement Study (HRS). Linear mixed-effects models estimated associations between falls and domain-specific cognitive decline (z-standardized) and rates of cognitive change. RESULTS Individuals with a single fall (pooled β = -0.007; 95% CI, -0.013 to -0.002; P = 0.006) and those with multiple falls (pooled β = -0.021; 95% CI, -0.026 to -0.016; P < 0.001) experienced a faster decline in global cognitive z scores compared to no history of falls. Similar patterns were observed across memory, executive, and orientation functions. DISCUSSION In this combined cohort study, including samples from ELSA and HRS, we discerned a marked association between the falls and domain-specific cognitive decline.
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