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Factors related to the high fall rate in long-term care residents with dementia

Published online by Cambridge University Press:  03 December 2014

Nienke M. Kosse ,
Maartje H. de Groot ,
Nicolas Vuillerme ,
Tibor Hortobágyi  and
Claudine J.C. Lamoth
Nienke M. Kosse*
Affiliation:
Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, the Netherlands University Grenoble-Alpes, FRE 3405 AGIM Laboratory, CNRS-UJF-UPMF-EPHE, La Tronche, France
Maartje H. de Groot
Affiliation:
Department of Geriatric Medicine, Slotervaart Hospital, Amsterdam, the Netherlands
Nicolas Vuillerme
Affiliation:
University Grenoble-Alpes, FRE 3405 AGIM Laboratory, CNRS-UJF-UPMF-EPHE, La Tronche, France Institut Universitaire de France, Paris, France
Tibor Hortobágyi
Affiliation:
Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, the Netherlands Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle-upon-Tyne, UK
Claudine J.C. Lamoth
Affiliation:
Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, the Netherlands
*
Correspondence should be addressed to: Nienke M. Kosse, MSc, University Medical Center Groningen, Center for Human Movement Sciences, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, the Netherlands. Phone: +31 50 363 2611; Fax: +31 50 363 3150. Email: n.m.kosse@gmail.com.
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Abstract

Background:

Falls in long-term care residents with dementia represent a costly but unresolved safety issue. The aim of the present study was to (1) determine the incidence of falls, fall-related injuries and fall circumstances, and (2) identify the relationship between patient characteristics and fall rate in long-term care residents with dementia.

Methods:

Twenty long-term care residents with dementia (80 ± 11 years; 60% male) participated. Falls were recorded on a standardized form, concerning fall injuries, time and place of fall and if the fall was witnessed. Patient characteristics (66 variables) were extracted from medical records and classified into the domains: demographics, activities of daily living, mobility, cognition and behavior, vision and hearing, medical conditions and medication use. We used partial least squares (PLS) regression to determine the relationship between patient characteristics and fall rate.

Results:

A total of 115 falls (5.1 ± 6.7 falls/person/year) occurred over 19 months, with 85% of the residents experiencing a fall, 29% of falls had serious consequences and 28% was witnessed. A combination of impaired mobility, indicators of disinhibited behavior, diabetes, and use of analgesics, beta blockers and psycholeptics were associated with higher fall rates. In contrast, immobility, heart failure, and the inability to communicate were associated with lower fall rates.

Conclusions:

Falls are frequent and mostly unwitnessed events in long-term care residents with dementia, highlighting the need for more effective and individualized fall prevention. Our analytical approach determined the relationship between a high fall rate and cognitive impairment, related to disinhibited behavior, in combination with mobility disability and fall-risk-increasing-drugs (FRIDs).

Keywords

accidental fallsdementiafall risk factorsnursing homepartial least square analyses
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 5 , May 2015 , pp. 803 - 814
Copyright
Copyright © International Psychogeriatric Association 2014 

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