Dementia as a risk factor for falls and fall injuries among nursing home residents.
OBJECTIVE
To compare rates of falling between nursing home residents with and without dementia and to examine dementia as an independent risk factor for falls and fall injuries.


METHODS
Prospective cohort study with 2 years of follow-up.


METHODS
Fifty-nine randomly selected nursing homes in Maryland, stratified by geographic region and facility size.


METHODS
Two thousand fifteen newly admitted residents aged 65 and older.


METHODS
During 2 years after nursing home admission, fall data were collected from nursing home charts and hospital discharge summaries.


RESULTS
The unadjusted fall rate for residents in the nursing home with dementia was 4.05 per year, compared with 2.33 falls per year for residents without dementia (P<.0001). The effect of dementia on the rate of falling persisted when known risk factors were taken into account. Among fall events, those occurring to residents with dementia were no more likely to result in injury than falls of residents without dementia, but, given the markedly higher rates of falling by residents with dementia, their rate of injurious falls was higher than for residents without dementia.


CONCLUSIONS
Dementia is an independent risk factor for falling. Although most falls do not result in injury, the fact that residents with dementia fall more often than their counterparts without dementia leaves them with a higher overall risk of sustaining injurious falls over time. Nursing home residents with dementia should be considered important candidates for fall-prevention and fall-injury-prevention strategies.
van Doorn
Carol
C
Department of Epidemiology and Preventive Medicine, School of Medicine, University of Maryland, Baltimore, Maryland 21201, USA. cvdoorn@yahoo.com
Gruber-Baldini
Ann L
AL
Zimmerman
Sheryl
S
Hebel
J Richard
JR
Port
Cynthia L
CL
Baumgarten
Mona
M
Quinn
Charlene C
CC
Taler
George
G
May
Conrad
C
Magaziner
Jay
J
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016001:Confidence Intervals; D003704:Dementia / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009735:Nursing Homes; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control