title: Memories of falling in elderly patients with dementia: response concordance rate and reproducibility.
abstract: BACKGROUND
  Although demented elderly patients have impaired memory, memories of falling are not uncommon. We aim to clarify reliability of memories of falling in such patients.
  
  
  METHODS
  Subjects included 62 patients (18 men, 44 women) diagnosed with dementia who resided in long-term care facilities. Mean age was 82.9 ± 7.8 years, mean Mini-Mental State Examination score was 16.4 ± 4.7 points, and mean Functional Independence Measure score was 67.9 ± 18.4 points. Subjects were asked a closed question about whether they were aware of having fallen (i.e. memories of falling) over the past year. Fear of falling was quantified using the visual analogue scale and FACES Pain Rating Scale. Scores were re-measured during retest approximately 10 days later to examine reproducibility of memories and fear of falling. Subjects whom staff had witnessed suffering a fall between baseline and retest session were excluded.
  
  
  RESULTS
  Fall memory concordance rate was 0.84, visual analogue scale reproducibility (correlation coefficient) was 0.98, and FACES Pain Rating Scale was 0.86. No differences in Mini-Mental State Examination scores were noted between groups for whom memories of falling were or were not reproducible. No correlation was observed among Mini-Mental State Examination, Functional Independence Measure scores, and intensity of fear of falling.
  
  
  CONCLUSIONS
  There was a high concordance rate for patients' memories of falling, which suggests that falls were retained as memories. No relationship was observed between memories of falling and degree of cognitive impairment, and severe dementia did not necessarily imply memories of falling were unreliable. The reproducibility of fear of falling suggested the intensity of fear of falling was not easily altered. It was possible memories of falling and fear of falling mutually interacted to reinforce and fixate with each other, leading to the observed phenomenon. Therefore, it appeared memories of falling were retained by patients; this fact can be used in fall prevention and vital function maintenance.
authors.affiliation: Department of Occupational Therapy, Faculty of Health Sciences, Health Science University, Fujikawaguchiko, Japan.|Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
authors.forename: Masayo
authors.initials: M
authors.lastname: Otaki
authors.affiliation: Department of Occupational Therapy, Faculty of Health Sciences, Health Science University, Fujikawaguchiko, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Moriguchi
authors.affiliation: Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
authors.forename: Adam
authors.initials: A
authors.lastname: Lebowitz
authors.affiliation: Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Asada
keywords: concordance in memories of falling; dementia; fear of falling; memories of falling; reproducibility of fear of falling