title: Identifying Fallers among Home Care Clients with Dementia and Parkinson's Disease.
abstract: Few studies have focused on falls among home care (HC) clients with neurological conditions. This study identified factors that increase risk of falling among HC clients with no recent history of falls, and explored whether risk profiles varied among those with dementia or parkinsonism compared to those without selected neurological conditions. A retrospective cohort design was used and analysis of data from community-based HC clients across Ontario was conducted on a sample of ambulatory clients with dementia, parkinsonism, or none of the selected neurological conditions. Data were obtained from the Resident Assessment Instrument for HC (RAI-HC) assessment. The outcome used in multivariable analyses was whether clients fell during follow-up. Unsteady gait was a strong predictor of falls across all three groups. Co-morbid parkinsonism most strongly predicted falls in the dementia group. Clients with borderline intact to mild cognitive impairment had higher odds of falling within the parkinsonism and comparison groups.
authors.affiliation: Department of Kinesiology,University of Waterloo.
authors.forename: Symron
authors.initials: S
authors.lastname: Bansal
authors.affiliation: School of Public Health and Health Systems,University of Waterloo.
authors.forename: John P
authors.initials: JP
authors.lastname: Hirdes
authors.affiliation: School of Pharmacy,University of Waterloo.
authors.forename: Colleen J
authors.initials: CJ
authors.lastname: Maxwell
authors.affiliation: Department of Medicine,McMaster University.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Papaioannou
authors.affiliation: Department of Kinesiology,University of Waterloo.
authors.forename: Lora M
authors.initials: LM
authors.lastname: Giangregorio
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000453:epidemiology; D015331:Cohort Studies; D003704:Dementia / Q000453:epidemiology*; D003863:Depression / Q000453:epidemiology; D004244:Dizziness / Q000453:epidemiology; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009864:Ontario / Q000453:epidemiology; D010300:Parkinson Disease / Q000453:epidemiology*; D019338:Polypharmacy; D012189:Retrospective Studies; D018570:Risk Assessment; D014786:Vision Disorders / Q000453:epidemiology
keywords: Parkinson’s disease; aging; chutes; dementia; falls; home care; instrument d’évaluation des residents en soins à domicile (IERSD); interRAI; maladie de Parkinson (parkinsonisme); soins à domicile; vieillissement