Factors associated with falls among older, cognitively impaired people in geriatric care settings: a population-based study.
OBJECTIVE
The authors studied factors associated with falls among cognitively impaired older people in geriatric care settings.


METHODS
This was a study using all geriatric care settings in a county in northern Sweden. Residents were assessed by means of the Multi-Dimensional Dementia Assessment Scale, supplemented with questions concerning the use of physical restraints, pain, previous falls during the stay, and falls and injuries during the preceding week. Data about both falls and cognition were collected in 3,323 residents age 65 and older. Of these residents 2,008 (60.4%) were cognitively impaired, and they became the study population. Of the participants, 69% were women; mean age: 83.5 years.


RESULTS
Of 2,008 cognitively impaired residents, 189 (9.4%) had fallen at least once during the preceding week. Being able to get up from a chair, previous falls, needing a helper when walking, and hyperactive symptoms were the factors most strongly associated with falls.


CONCLUSIONS
Preventing falls in cognitively impaired older people is particularly difficult. An intervention strategy would probably have to include treatment of psychiatric and behavioral symptoms, improvement of gait and balance, and adjustment of drug treatment, as well as careful staff supervision.
Kallin
Kristina
K
Dept. of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-901 87 Umeå, Sweden. kristina.kallin@germed.umu.se
Gustafson
Yngve
Y
Sandman
Per-Olof
PO
Karlsson
Stig
S
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology*; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence