Risk factors for falls among residents with dementia living in group dwellings.
BACKGROUND
Falls are a major cause of morbidity and mortality among elderly people, and people with dementia run an increased risk of falling. The aim of this study is to identify risk factors for falls in people with dementia.


METHODS
The study was performed over a six-month period in northern Sweden using a sample of 160 residents living in 20 group dwellings for people with dementia.


RESULTS
Sixty-four residents (40%) sustained at least one fall during the period. The total number of falls during the study period was 191, and the fall incidence was 2.6 per person year (169 falls/130 residents). Using logistic regression analysis, the independent risk factors strongly associated with falling were: requiring help with hygiene, displaying verbally disruptive/attention-seeking behavior, able to rise from a chair, walking with assistive devices, and participating in outdoor walks. These factors explained 36.1% of the variance in falls with a concordance of 79.6%. Thirty-five percent of the falls occurred between 9 pm and 6 am, with a peak between 5 pm and 6 pm. Symptoms preceding the falls were anxiety (31.1%) and confusion (13.3%).


CONCLUSIONS
Among residents with dementia it is important to identify those who run an increased risk of falling and need more careful supervision, especially in the evening and during the night. In addition, the causes of anxiety and confusion have to be prevented and treated.
Department of Community and Rehabiliation, Geriatric Medicine, Umeå University, Umeå, Sweden. Tony.Pellfolk@germed.umu.se
Tony
T
Pellfolk
Ted
T
Gustafsson
Yngve
Y
Gustafson
Stig
S
Karlsson
D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D003704:Dementia / Q000453:epidemiology*; D004185:Disability Evaluation; D005260:Female; D016352:Group Homes / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007318:Inservice Training; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012307:Risk Factors; D012931:Social Environment; D013548:Sweden