Executive functioning and predictors of falls in the rehabilitation setting.
OBJECTIVE
To examine the incremental utility of executive function tests in the prediction of inpatient falls.


METHODS
Evaluation of neuropsychologic and medical risk factors for fall was completed at admission. Inpatient falls were tabulated following discharge.


METHODS
A freestanding, urban rehabilitation hospital.


METHODS
Ninety consecutive admissions to traumatic brain injury, orthopedic, and spinal cord injury wards. Age of the participants ranged from 17 to 73 years old.


METHODS
Incident reports of inpatient falls.


RESULTS
Standard multiple regression analyses indicated that measures of executive functioning sensitive to self-monitoring accounted for unique variance in falls beyond that explained by age and functional motor ability as assessed by the Functional Independence Measure. Visuospatial functioning, although not directly related to falls, was a significant predictor in combination with measures of executive functioning. Together, these variables accounted for 30.3% of the variance in inpatient falls (multiple r = .55; p < .001).


CONCLUSIONS
The findings suggest that the influence of motor and sensory impairments on falls are moderated, in part, by executive functioning. Patients with intact executive functioning are less likely to act in ways that could result in a fall; thus, aggressive fall prevention measures may be unnecessary. In contrast, executive dysfunction may signal the need for intervention, even among patients whose profiles are unremarkable with regard to traditional risk factors for fall.
Rapport
L J
LJ
Department of Psychology, Wayne State University, Detroit, MI 48202, USA.
Hanks
R A
RA
Millis
S R
SR
Deshpande
S A
SA
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003071:Cognition; D005260:Female; D006801:Humans; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011597:Psychomotor Performance; D012044:Regression Analysis; D012047:Rehabilitation Centers; D012307:Risk Factors