title: Factors related to the high fall rate in long-term care residents with dementia.
abstract: BACKGROUND
  Falls in long-term care residents with dementia represent a costly but unresolved safety issue. The aim of the present study was to (1) determine the incidence of falls, fall-related injuries and fall circumstances, and (2) identify the relationship between patient characteristics and fall rate in long-term care residents with dementia.
  
  
  METHODS
  Twenty long-term care residents with dementia (80 ± 11 years; 60% male) participated. Falls were recorded on a standardized form, concerning fall injuries, time and place of fall and if the fall was witnessed. Patient characteristics (66 variables) were extracted from medical records and classified into the domains: demographics, activities of daily living, mobility, cognition and behavior, vision and hearing, medical conditions and medication use. We used partial least squares (PLS) regression to determine the relationship between patient characteristics and fall rate.
  
  
  RESULTS
  A total of 115 falls (5.1 ± 6.7 falls/person/year) occurred over 19 months, with 85% of the residents experiencing a fall, 29% of falls had serious consequences and 28% was witnessed. A combination of impaired mobility, indicators of disinhibited behavior, diabetes, and use of analgesics, beta blockers and psycholeptics were associated with higher fall rates. In contrast, immobility, heart failure, and the inability to communicate were associated with lower fall rates.
  
  
  CONCLUSIONS
  Falls are frequent and mostly unwitnessed events in long-term care residents with dementia, highlighting the need for more effective and individualized fall prevention. Our analytical approach determined the relationship between a high fall rate and cognitive impairment, related to disinhibited behavior, in combination with mobility disability and fall-risk-increasing-drugs (FRIDs).
authors.affiliation: Center for Human Movement Sciences,University Medical Center Groningen,University of Groningen,the Netherlands.
authors.forename: Nienke M
authors.initials: NM
authors.lastname: Kosse
authors.affiliation: Department of Geriatric Medicine,Slotervaart Hospital,Amsterdam,the Netherlands.
authors.forename: Maartje H
authors.initials: MH
authors.lastname: de Groot
authors.affiliation: University Grenoble-Alpes,FRE 3405 AGIM Laboratory,CNRS-UJF-UPMF-EPHE,La Tronche,France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Vuillerme
authors.affiliation: Center for Human Movement Sciences,University Medical Center Groningen,University of Groningen,the Netherlands.
authors.forename: Tibor
authors.initials: T
authors.lastname: Hortobágyi
authors.affiliation: Center for Human Movement Sciences,University Medical Center Groningen,University of Groningen,the Netherlands.
authors.forename: Claudine J C
authors.initials: CJ
authors.lastname: Lamoth
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D008134:Long-Term Care / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes / Q000706:statistics & numerical data*; D012307:Risk Factors
keywords: partial least square analyses