Incidence and prediction of falls in dementia: a prospective study in older
Citation:
Allan LM, Ballard CG, Rowan EN, Kenny RA, Incidence and prediction of falls in dementia: a prospective study in older, PLoS ONE, 4, (5), 2009, e5521Download Item:
Abstract:
Background: Falls are a major cause of morbidity and mortality in dementia, but there have been no prospective studies of
risk factors for falling specific to this patient population, and no successful falls intervention/prevention trials. This
prospective study aimed to identify modifiable risk factors for falling in older people with mild to moderate dementia.
Methods and Findings: 179 participants aged over 65 years were recruited from outpatient clinics in the UK (38 Alzheimer?s
disease (AD), 32 Vascular dementia (VAD), 30 Dementia with Lewy bodies (DLB), 40 Parkinson?s disease with dementia (PDD),
39 healthy controls). A multifactorial assessment of baseline risk factors was performed and fall diaries were completed
prospectively for 12 months. Dementia participants experienced nearly 8 times more incident falls (9118/1000 person-years)
than controls (1023/1000 person-years; incidence density ratio: 7.58, 3.11?18.5). In dementia, significant univariate
predictors of sustaining at least one fall included diagnosis of Lewy body disorder (proportional hazard ratio (HR) adjusted
for age and sex: 3.33, 2.11?5.26), and history of falls in the preceding 12 months (HR: 2.52, 1.52?4.17). In multivariate
analyses, significant potentially modifiable predictors were symptomatic orthostatic hypotension (HR: 2.13, 1.19?3.80),
autonomic symptom score (HR per point 0?36: 1.055, 1.012?1.099), and Cornell depression score (HR per point 0?40: 1.053,
1.01?1.099). Higher levels of physical activity were protective (HR per point 0?9: 0.827, 0.716?0.956).
Conclusions: The management of symptomatic orthostatic hypotension, autonomic symptoms and depression, and the
encouragement of physical activity may provide the core elements for the most fruitful strategy to reduce falls in people
with dementia. Randomised controlled trials to assess such a strategy are a priority.
Author's Homepage:
http://people.tcd.ie/rkennyDescription:
PUBLISHEDPMID: 19346724
Author: KENNY, ROSE
Type of material:
Journal ArticleSeries/Report no:
PLoS ONE4
(5)
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Full text availableKeywords:
Medical GerontologySubject (TCD):
Ageing , NeuroscienceDOI:
http://dx.doi:10.1371/journal.pone.0005521Metadata
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