title: Visual spatial abilities and fall risk: an assessment tool for individuals with dementia.
abstract: Risk of falling is a major concern of long-term care facilities with residents diagnosed with dementia. Use of a brief cognitive assessment focusing on visual spatial abilities could be one strategy in the prevention of falls in residents with dementia. The objective of this study was to determine if a clock test could predict a risk of falls in residents diagnosed with dementia. Three hundred sixty-four individuals with dementia participated (92 men and 272 women; ages 37 to 100, mean 80.5 years, median 83 years). Each participant was given the Reality Comprehension Clock Test (RCCT) three times, and Mini Mental-Status Examination (MMSE) two times to determine criterion-related validity, test-retest reliability, internal consistency; and to set and evaluate a risk of falls score based on the Visual Spatial Score (VSS) component produced by the RCCT. Significant findings included .72 (p < .01) correlation between the RCCT and the MMSE, .90 (p < .01) correlation between the first administration of the RCCT and the second administration of the RCCT; an alpha of .95 (p, < .001) and an F value of 7.6 (p < .001) producing a risk of falls initial VSS of 5 or lower compared to 9 or greater. Chi-square of 6.3 for 30 days (p,< .01), 11.08 for 60 days (p < .01) and 13.3 for 90 days (p < .01) indicated a significant difference in the number of falls occurring in the high risk group (VSS of 5 or lower) compared to the low/ no risk group (VSS of 9 or higher). A risk factor analysis suggested that residents in the higher risk group were three times more likely to have fallen than residents in the low risk group. Knowing a resident's visual spatial ability offers health care providers an opportunity to implement a resident-specific intervention that addresses their cognitive ability and visual spatial deficit that may reduce the resident's risk of falling.
authors.affiliation: School of Professional Studies, The State University of New York at Cortland, USA.
authors.forename: Roy H
authors.initials: RH
authors.lastname: Olsson
authors.forename: Suzanne
authors.initials: S
authors.lastname: Wambold
authors.forename: Barbara
authors.initials: B
authors.lastname: Brock
authors.forename: Diana
authors.initials: D
authors.lastname: Waugh
authors.forename: Heather
authors.initials: H
authors.lastname: Sprague
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000175:diagnosis*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D005851:Geriatric Nursing / Q000379:methods; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards*; D009730:Nursing Assessment / Q000379:methods*; D011237:Predictive Value of Tests; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013037:Spatial Behavior; D015351:Vision Screening / Q000379:methods