The Association Between Mild Cognitive Impairment and Fall Risk in Older Adults Attending Rural District Hospitals in Karnataka: A Cross-Sectional Study

Objectives To examine the association between global cognition, functional mobility, lower limb strength, and fall history among older adults with mild cognitive impairment (MCI) attending rural district hospitals in Karnataka, using culturally appropriate assessment tools. Material and Methods This cross-sectional clinical exploratory pilot study was conducted at Brain Health Clinics established under the Karnataka Brain Health Initiative in district hospitals of Karnataka. Thirty-two community-dwelling adults aged 60 years and above with MCI were included. Global cognition was assessed using the Hindi mental status examination (HMSE), administered in Kannada translation. Functional mobility was assessed using the timed up and go (TUG) test, lower limb strength using the 30-s chair stand test (30s-CST) and fall history over the preceding year was documented by self-report, and data were analysed using SPSS v27 with Spearman’s rank correlation. Results Mean age was 66.4 years (SD 10.2); 62.5% were female. Median TUG time was 13 s (IQR 10–22), median falls in the past year were 2 (IQR 2–3), median chair stand was 8 repetitions (IQR 5–12), and median HMSE score was 24 (IQR 19.8–26). Slower TUG performance was strongly associated with higher fall frequency (rho = 0.61, p <0.001). Lower HMSE scores were moderately associated with increased fall frequency (rho = −0.37, p = 0.04). Reduced lower limb strength demonstrated a moderate association with impaired functional mobility (rho = −0.50, p = 0.003). Conclusion MCI was associated with impaired mobility and greater fall frequency among older adults attending rural district hospitals in Karnataka. These findings suggest that integrating brief cognitive screening with functional mobility assessment may help identify individuals at elevated fall risk in low-resource clinical settings. Given the exploratory nature of this study, larger prospective studies are needed to establish the generalisability of these associations and determine whether early physiotherapy-led interventions can effectively reduce fall risk in older adults with Mild Cognitive Impairment.