title: Physical restraint use and falls in nursing homes: a comparison between residents with and without dementia.
abstract: OBJECTIVE
  To estimate the use of different types of physical restraints and assess their associations to falls and injuries among residents with and without Alzheimer's disease (AD) or dementia in US nursing homes.
  
  
  METHODS
  Data were from the 2004 National Nursing Home Survey. AD or dementia was identified using International Classification of Diseases, Ninth Revision (ICD-9) codes. Analyses were conducted with the Surveyfreq and Surveylogistic procedures in SAS v.9.1.
  
  
  RESULTS
  Residents with either AD or dementia were more likely to be physically restrained (9.99% vs 3.91%, P < .001) and less likely to have bed rails (35.06% vs 38.43%, P < .001) than those residents without the disease. The use of trunk restraints was associated with higher risk for falls (adjusted odds ratio [AOR] = 1.66, P < .001) and fractures (AOR = 2.77, P < .01) among residents with the disease. The use of full bed rails was associated with lower risk for falls among residents with and without the disease (AOR = 0.67 and AOR = 0.72, Ps < .05, respectively).
  
  
  CONCLUSIONS
  The use of a trunk restraint is associated with a higher risk for falls and fractures among residents with either AD or dementia.
authors.affiliation: Department of Health Care Management, Mount Olive College, NC, USA. hluo@moc.edu
authors.forename: Huabin
authors.initials: H
authors.lastname: Luo
authors.forename: Michael
authors.initials: M
authors.lastname: Lin
authors.forename: Nicholas
authors.initials: N
authors.lastname: Castle
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000628:therapy; D003704:Dementia / Q000150:complications / Q000628:therapy*; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000517:prevention & control; D019538:Health Care Surveys; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data; D012149:Restraint, Physical / Q000379:methods / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology