title: Delirium markers in older fallers: a case-control study.
abstract: BACKGROUND
  When a hospitalized older patient falls or develops delirium, there are significant consequences for the patient and the health care system. Assessments of inattention and altered consciousness, markers for delirium, were analyzed to determine if they were also associated with falls.
  
  
  METHODS
  This retrospective case-control study from a regional tertiary Veterans Affairs referral center identified falls and delirium risk factors from quality databases from 2010 to 2012. Older fallers with complete delirium risk assessments prior to falling were identified. As a control, non-fallers were matched at a 3:1 ratio. Admission risk factors that were compared in fallers and non-fallers included altered consciousness, cognitive performance, attention, sensory deficits, and dehydration. Odds ratio (OR) was reported (95% confidence interval [CI]).
  
  
  RESULTS
  After identifying 67 fallers, the control population (n=201) was matched on age (74.4±9.8 years) and ward (83.6% medical; 16.4% intensive care unit). Inattention as assessed by the Months of the Year Backward test was more common in fallers (67.2% versus 50.8%, OR=2.0; 95% CI: 1.1-3.7). Fallers tended to have altered consciousness prior to falling (28.4% versus 12.4%, OR=2.8; 95% CI: 1.3-5.8).
  
  
  CONCLUSIONS
  In this case-control study, alterations in consciousness and inattention, assessed prior to falling, were more common in patients who fell. Brief assessments of consciousness and attention should be considered for inclusion in fall prediction.
authors.affiliation: Geriatric Research, Education, and Clinical Center, VA Boston Healthcare System, Boston, MA, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Doherty
authors.affiliation: Geriatric Research, Education, and Clinical Center, VA Boston Healthcare System, Boston, MA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Archambault
authors.affiliation: Geriatric Research, Education, and Clinical Center, VA Boston Healthcare System, Boston, MA, USA ; School of Nursing, Science & Health Professions, Regis College, Boston, MA, USA.
authors.forename: Brittany
authors.initials: B
authors.lastname: Kelly
authors.affiliation: Geriatric Research, Education, and Clinical Center, VA Boston Healthcare System, Boston, MA, USA ; Division of Aging, Brigham and Women's Hospital, Boston, MA, USA ; Harvard Medical School, Boston, MA, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Rudolph
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001288:Attention; D016022:Case-Control Studies; D003071:Cognition; D003244:Consciousness Disorders / Q000453:epidemiology*; D003693:Delirium / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs
keywords: geriatrics; patient centered outcomes research; patient safety