Subcortical vascular lesions predict falls at 12 months in elderly patients discharged from a rehabilitation ward.
OBJECTIVE
To test whether subcortical vascular lesions are associated with falls in elderly patients with gait disorder discharged from a rehabilitation ward.


METHODS
Secondary 12-month follow-up analysis of an observational survey focusing on the prevalence of subcortical vascular lesions in a population of elderly patients discharged from rehabilitation hospitals.


METHODS
A rehabilitation and aged care unit.


METHODS
Consecutively admitted elderly patients (N=214) with gait disorder.


METHODS
Not applicable.


METHODS
On admission, all patients underwent comprehensive geriatric assessment including sociodemographics, cognitive and depressive symptoms, nutritional status, physical health, and functional status. Subcortical vascular lesions were assessed on computed tomography films with a validated rating scale. All patients received a standardized rehabilitative program. Twelve months after discharge, all patients were interviewed by telephone, mainly focusing on the occurrence of falls during the follow-up period. Potential predictors of falls were assessed in univariate and multivariate analyses.


RESULTS
Univariate predictors of falls were age, sex, Mini-Mental State Examination, Barthel Index on admission, and subcortical vascular lesions. In multivariate analyses, subcortical vascular lesions were the only significant predictor of risk of falling; patients with moderate and severe subcortical vascular lesions scores had a greater risk of falling (odds ratio [OR]=3.0; 95% confidence interval [CI], 1.3-7.1; P=.012; OR=3.9; 95% CI, 1.6-9.2; P=.002, respectively) than those with no subcortical vascular lesions.


CONCLUSIONS
Subcortical vascular lesions are associated with falls at 12 months in elderly patients with gait disorder discharged from a rehabilitative ward. Future research is needed to confirm our results.
Guerini
Fabio
F
Rehabilitation and Aged Care Unit Ancelle della Carità Hospital, Cremona, Italy.
Frisoni
Giovanni B
GB
Marrè
Alessandra
A
Turco
Renato
R
Bellelli
Giuseppe
G
Trabucchi
Marco
M
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D015984:Causality; D002544:Cerebral Infarction / Q000175:diagnosis / Q000453:epidemiology*; D003072:Cognition Disorders / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006707:Homes for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D015999:Multivariate Analysis; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*