title: Urinary incontinence: an under-recognized risk factor for falls among elderly dementia patients.
abstract: OBJECTIVE
  Elderly people with dementia are at increased risk of falls and intervention trials to prevent falls have failed to demonstrate clinical effectiveness in this population. This study evaluates the role of urinary incontinence as a fall risk factor in older patients with dementia, with the aim of developing relevant intervention strategies.
  
  
  METHODS
  Elderly patients with dementia visiting our center were recruited. All subjects underwent a Comprehensive Geriatric Assessment (CGA), and patients were divided into two groups (fall and non-fall) according to their history of falls in the past year. Components of the CGA, including physical function, mental function, depressive symptoms, incontinence, and nutritional status, were evaluated according to fall history.
  
  
  RESULTS
  Overall, 159 patients with dementia (mean age 77.3 ± 9.0 years, 59.1% male) participated. Fifty-four patients (34.0%) had experienced falls in the past year. Among all subjects, 50.3% were diagnosed with mild dementia, 37.7% with moderate dementia, and 12.0% with severe dementia according to an established Clinical Dementia Rating scale. Subjects in the fall group displayed poorer physical function, balance, depressive mood, nutritional status, urinary incontinence, and had an increased prevalence of polypharmacy. However, multivariate analysis revealed urinary incontinence as the only independent risk factor for falls (OR = 4.9 ± 2.2, 95% CI: 2.0-12.0, P < 0.001).
  
  
  CONCLUSIONS
  Urinary incontinence is a previously unidentified risk factor for falls among elderly dementia patients. An interventional study with the focus of urinary incontinence could improve the effectiveness of fall prevention among these patients.
authors.affiliation: Geriatric Medicine Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
authors.forename: Chun-Ying
authors.initials: CY
authors.lastname: Lee
authors.forename: Liang-Kung
authors.initials: LK
authors.lastname: Chen
authors.forename: Yuk-Keung
authors.initials: YK
authors.lastname: Lo
authors.forename: Chih-Kuang
authors.initials: CK
authors.lastname: Liang
authors.forename: Ming-Yueh
authors.initials: MY
authors.lastname: Chou
authors.forename: Chung-Cheng
authors.initials: CC
authors.lastname: Lo
authors.forename: Chia-Tsuan
authors.initials: CT
authors.lastname: Huang
authors.forename: Yu-Te
authors.initials: YT
authors.lastname: Lin
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003704:Dementia / Q000453:epidemiology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014549:Urinary Incontinence / Q000453:epidemiology*