title: Factors associated with falls among older, cognitively impaired people in geriatric care settings: a population-based study.
abstract: 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.
authors.affiliation: Dept. of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, SE-901 87 Umeå, Sweden. kristina.kallin@germed.umu.se
authors.forename: Kristina
authors.initials: K
authors.lastname: Kallin
authors.forename: Yngve
authors.initials: Y
authors.lastname: Gustafson
authors.forename: Per-Olof
authors.initials: PO
authors.lastname: Sandman
authors.forename: Stig
authors.initials: S
authors.lastname: Karlsson
mesh_terms: 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