title: Emotional and psychological distress of persons involved in the care of patients with Alzheimer disease predicts falls and fractures in their care recipients.
abstract: OBJECTIVE
  Elderly patients with dementia have a higher risk of falls and fractures as compared to cognitively intact elderly subjects. To investigate whether psychological distress of the caregiver might predispose older persons with Alzheimer disease (AD) to falls and fractures, we performed a prospective cohort study.
  
  
  METHODS
  A consecutive series of 110 subjects with dementia underwent baseline and follow-up clinical and functional evaluations. The burden of the caregivers was recorded at baseline. Any intervening fall or fracture was ascertained at the 1-year follow-up.
  
  
  RESULTS
  The caregiver burden was significantly higher in persons involved in the care of patients with AD who subsequently fell. In a multivariate regression model, the caregiver burden score predicted falls and fractures.
  
  
  CONCLUSIONS
  Part of the increased risk of falls and fractures in AD might be due to the distress of caregivers, a factor potentially amenable to treatment.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy. dariomaggio@hotmail.com
authors.forename: Dario
authors.initials: D
authors.lastname: Maggio
authors.forename: Sara
authors.initials: S
authors.lastname: Ercolani
authors.forename: Sonia
authors.initials: S
authors.lastname: Andreani
authors.forename: Carmelinda
authors.initials: C
authors.lastname: Ruggiero
authors.forename: Elena
authors.initials: E
authors.lastname: Mariani
authors.forename: Francesca
authors.initials: F
authors.lastname: Mangialasche
authors.forename: Nicola
authors.initials: N
authors.lastname: Palmari
authors.forename: Patrizia
authors.initials: P
authors.lastname: Mecocci
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D000544:Alzheimer Disease / Q000150:complications*; D017028:Caregivers / Q000523:psychology*; D003071:Cognition / Q000502:physiology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005544:Forecasting; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012306:Risk; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology*