Risk factors for recurrent injurious falls that require hospitalization for older adults with dementia: a population based study.
BACKGROUND
Older adults with dementia are at an increased risk of falls, however, little is known about risk factors for recurrent injurious falls (a subsequent fall after the first fall has occurred) among this group. This study aimed to identify risk factors for recurrent injurious falls requiring hospitalization among adults aged 60+ years with dementia.


METHODS
This retrospective, whole-population cohort study was conducted using the Western Australian Hospital Morbidity Data System and Western Australian Death Registrations from 2001 to 2013. Survival analysis using a stratified conditional Cox model (type 1) was undertaken to identify risk factors for recurrent injurious falls requiring hospitalization.


RESULTS
There were 32,519 participants with an index hospital admission with dementia during the study period. Over 27 % (n = 8970) of the cohort experienced a total of 11,073 injurious falls requiring hospitalization during follow up with 7297 individuals experiencing a single fall, 1330 experiencing two falls and 343 experiencing three or more falls. The median follow-up time for each individual was 2.49 years. Females were at a significantly increased risk of 7 % for recurrent injurious falls resulting in hospitalization (adjusted hazard ratio 1.07, 95 % CI 1.01-1.12), compared to males. Increasing age, living in rural areas, and having an injurious fall in the year prior to the index hospital admission with dementia also increased the risk of recurrent injurious falls resulting in hospitalization.


CONCLUSIONS
Screening those with dementia for injurious falls history could help to identify those most at risk of recurrent injurious falls. Improvement of heath care and falls prevention services for those with dementia who live in rural areas may also reduce recurrent injurious falls.
Curtin-Monash Accident Research Centre (C-MARC), Curtin University, GPO Box U1987, Perth, 6845, WA, Australia.|Eye & Vision Epidemiology Research Group (EVER), Perth, WA, Australia.
Lynn B
LB
Meuleners
Curtin-Monash Accident Research Centre (C-MARC), Curtin University, GPO Box U1987, Perth, 6845, WA, Australia. M.Fraser@curtin.edu.au.|Eye & Vision Epidemiology Research Group (EVER), Perth, WA, Australia. M.Fraser@curtin.edu.au.
Michelle L
ML
Fraser
Institute for Health Research, The University of Notre Dame, Fremantle, 6959, WA, Australia.
Max K
MK
Bulsara
Curtin-Monash Accident Research Centre (C-MARC), Curtin University, GPO Box U1987, Perth, 6845, WA, Australia.
Kyle
K
Chow
Eye & Vision Epidemiology Research Group (EVER), Perth, WA, Australia.|Centre for Health Services Research, School Of Population Health, The University of Western Australia, 35 Stirling Highway, Crawley, 6009, WA, Australia.
Jonathon Q
JQ
Ng
Dementia; Hospitalization; Population-based study; Recurrent falls
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