title: Falls and risk factors for falls in community-dwelling adults with dementia (NutriAlz trial).
abstract: To estimate the number of fallers and risk factors for falls in a cohort with dementia, we did a secondary analysis of a cluster-randomized controlled trial (NutriAlz) in 11 outpatient and day care centers in Catalonia (Spain) including 626 community-dwelling patients with dementia, followed for 12 months. Participants' characteristics were assessed at baseline, at 6 and 12 months [fall in the earlier 6 mo, anthropometric data, comorbidities, Mini-Mental State Examination, Clinical Dementia Rating, Basic Activities of Daily Living (BADL), Instrumental Activities of Daily Living, Neuropsychiatric Inventory Questionnaire, Zarit Caregiver Burden Interview and Mini-Nutritional Assessment]. Multivariate logistic regression models and generalized linear models were used to explore risk factors for falls and changes in health and function. Two hundred twenty-three participants fell during the 12 months follow-up (35.62%). Risk factors identified for falls were age (odds ratio (OR)=1.03, 95% confidence interval (CI), 1.00-1.05), BADL (OR=1.18, 95% CI, 1.05-1.32), and earlier fall (OR=2.30, 95% CI, 1.57-3.35). Fallers had worse health than nonfallers, and their dependence increased significantly more in BADL during the study, compared with nonfallers. Dependence in BADL is a risk factor and a consequence of falls; interventions aimed at preventing falls in dementia patients could promote autonomy in BADL and slow its decline.
authors.affiliation: Institut de l'Envelliment, Universitat Autònoma de Barcelona, Sant Pau Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Salvà
authors.forename: Marta
authors.initials: M
authors.lastname: Roqué
authors.forename: Xavier
authors.initials: X
authors.lastname: Rojano
authors.forename: Marco
authors.initials: M
authors.lastname: Inzitari
authors.forename: Sandrine
authors.initials: S
authors.lastname: Andrieu
authors.forename: Eduardo J
authors.initials: EJ
authors.lastname: Schiffrin
authors.forename: Yves
authors.initials: Y
authors.lastname: Guigoz
authors.forename: Bruno
authors.initials: B
authors.lastname: Vellas
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data*; D000203:Activities of Daily Living / Q000523:psychology; D000544:Alzheimer Disease; D015331:Cohort Studies; D003704:Dementia / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D016032:Randomized Controlled Trials as Topic; D012111:Residence Characteristics; D012307:Risk Factors; D013030:Spain; D011795:Surveys and Questionnaires