Influence of cognitive impairment on fall risk among elderly nursing home residents

2016 ◽  
Vol 28 (12) ◽  
pp. 1975-1987 ◽  
Author(s):  
M. Seijo-Martinez ◽  
J. M. Cancela ◽  
C. Ayán ◽  
S. Varela ◽  
H. Vila
Keyword(s):  
Risk Factors ◽  
Nursing Home ◽  
Cognitive Impairment ◽  
Fall Risk ◽  
Risk Model ◽  
Nursing Home Residents ◽  
Functional Mobility ◽  
Nursing Home Care ◽  
Fall Risk Factors ◽  
Activity Performance

ABSTRACTBackground:Information relating the severity of cognitive decline to the fall risk in institutionalized older adults is still scarce. This study aims to identify potential fall risk factors (medications, behavior, motor function, and neuropsychological disturbances) depending on the severity of cognitive impairment in nursing home residents.Methods:A total of 1,167 nursing home residents (mean age 81.44 ± 8.26 years; 66.4% women) participated in the study. According to the MEC, (the Spanish version of the Mini-Mental State Examination) three levels of cognitive impairment were established: mild (20–24) “MCI”, moderate (14–19) “MOCI”, and severe (≤14) “SCI”. Scores above 24 points indicated the absence cognitive impairment (NCI). Information regarding fall history and fall risk during the previous year was collected using standardized questionnaires and tests.Results:Sixty falls (34%) were registered among NCI participants and 417 (43%) among people with cognitive impairment (MCI: 35%; MOCI: 40%; SCI: 50%). A different fall risk model was observed for MCI, MOCI, SCI, and NCI patients. The results imply that the higher the level of cognitive impairment, the greater the number of falls (F1,481= 113.852; Sig = 0.015), although the level of significance was not maintained when MOCI and SCI participants were compared. Depression, neuropsychiatric disturbances, autonomy constraints in daily life activity performance, and low functional mobility were factors closely associated with fall risk.Conclusion:This study provides evidence indicating that fall risk factors do not hold a direct correlation with the level of cognitive impairment among elderly nursing home care residents.

scholarly journals Improving prediction of fall risk among nursing home residents using electronic medical records

2015 ◽  
Vol 23 (2) ◽  
pp. 276-282 ◽  
Author(s):  
Allison Marier ◽  
Lauren E.W. Olsho ◽  
William Rhodes ◽  
William D. Spector
Keyword(s):  
Risk Factors ◽  
Nursing Home ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Fall Risk ◽  
Nursing Home Residents ◽  
Additional Risk Factor ◽  
Data Set ◽  
Regression Parameters ◽  
Fall Risk Factors

Abstract Objective Falls are physically and financially costly, but may be preventable with targeted intervention. The Minimum Data Set (MDS) is one potential source of information on fall risk factors among nursing home residents, but its limited breadth and relatively infrequent updates may limit its practical utility. Richer, more frequently updated data from electronic medical records (EMRs) may improve ability to identify individuals at highest risk for falls. Methods The authors applied a repeated events survival model to analyze MDS 3.0 and EMR data for 5129 residents in 13 nursing homes within a single large California chain that uses a centralized EMR system from a leading vendor. Estimated regression parameters were used to project resident fall probability. The authors examined the proportion of observed falls within each projected fall risk decile to assess improvements in predictive power from including EMR data. Results In a model incorporating fall risk factors from the MDS only, 28.6% of observed falls occurred among residents in the highest projected risk decile. In an alternative specification incorporating more frequently updated measures for the same risk factors from the EMR data, 32.3% of observed falls occurred among residents in the highest projected risk decile, a 13% increase over the base MDS-only specification. Conclusions Incorporating EMR data improves ability to identify those at highest risk for falls relative to prediction using MDS data alone. These improvements stem chiefly from the greater frequency with which EMR data are updated, with minimal additional gains from availability of additional risk factor variables.

Studying Fall Risk Factors Among Nursing Home Residents Who Fell

2001 ◽  
Vol 27 (10) ◽  
pp. 26-34 ◽  
Author(s):  
Barbara Harrison ◽  
Dorothy Booth ◽  
Donna Algase
Keyword(s):  
Risk Factors ◽  
Nursing Home ◽  
Fall Risk ◽  
Nursing Home Residents ◽  
Fall Risk Factors

scholarly journals Advanced cognitive impairment among older nursing home residents

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tadeja Gracner ◽  
Patricia W. Stone ◽  
Mansi Agarwal ◽  
Mark Sorbero ◽  
Susan L Mitchell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Nursing Home ◽  
Cognitive Impairment ◽  
Mortality Risk ◽  
Advanced Disease ◽  
Nursing Home Residents ◽  
Functional Score ◽  
Data Set

Abstract Background Though work has been done studying nursing home (NH) residents with either advanced Alzheimer’s disease (AD) or Alzheimer’s disease related dementia (ADRD), none have distinguished between them; even though their clinical features affecting survival are different. In this study, we compared mortality risk factors and survival between NH residents with advanced AD and those with advanced ADRD. Methods This is a retrospective observational study, in which we examined a sample of 34,493 U.S. NH residents aged 65 and over in the Minimum Data Set (2011–2013). Incident assessment of advanced disease was defined as the first MDS assessment with severe cognitive impairment (Cognitive Functional Score equals to 4) and diagnoses of AD or ADRD. Demographics, functional limitations, and comorbidities were evaluated as mortality risk factors using Cox models. Survival was characterized with Kaplan-Maier functions. Results Of those with advanced cognitive impairment, 35 % had AD and 65 % ADRD. At the incident assessment of advanced disease, those with AD had better health compared to those with ADRD. Mortality risk factors were similar between groups (shortness of breath, difficulties eating, substantial weight-loss, diabetes mellitus, heart failure, chronic obstructive pulmonary disease, and pneumonia; all p < 0.01). However, stroke and difficulty with transfer (for women) were significant mortality risk factors only for those with advanced AD. Urinary tract infection, and hypertension (for women) only were mortality risk factors for those with advanced ADRD. Median survival was significantly shorter for the advanced ADRD group (194 days) compared to the advanced AD group (300 days). Conclusions There were distinct mortality and survival patterns of NH residents with advanced AD and ADRD. This may help with care planning decisions regarding therapeutic and palliative care.

scholarly journals Characteristics of falls in mild and moderate Alzheimer's disease

2009 ◽  
Vol 3 (4) ◽  
pp. 337-343 ◽  
Author(s):  
Eliane Mayumi Kato-Narita ◽  
Marcia Radanovic
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Fall Risk ◽  
Environmental Risks ◽  
Prevention Strategies ◽  
Effective Prevention ◽  
Fall Risk Factors ◽  
Functional Stimulation ◽  
Increasing Risk ◽  
Effective Prevention Strategies

Abstract The occurrence of falls in AD patients is frequent, and their consequences are cognitive decline, fractures and loss of independence. Many studies have addressed fall risk factors in order to establish effective prevention strategies. Objectives: We describe the frequency and characteristics of falls in a sample of AD patients and their main risk factors. Methods: We evaluated 40 subjects without cognitive impairment, and 45 AD patients, graded as CDR 1 and CDR 2. Results: Environmental hazard risks were the most frequent cause associated with falls in CDR 1 (41.4%) and CDR 2 (46.7%). Instability (31%) and dizziness (17.2%) were frequent causes of falls in the CDR 1 group, and this group showed the highest rate of recurrence (28%). In both groups of AD patients, indoors falls predominated (70.3 and 80% respectively for CDR 1 and 2). In our sample, the remaining factors studied were not associated with increasing risk for falls. Conclusions: These results reinforce the hypothesis that falls in AD are mutifactorial and that their risk factors are highly interconnected. Preventative strategies considering all aspects should be implemented most crucially eliminating environmental risks, maintaining constant presence of caregivers, and providing physical and functional stimulation, both in mild and moderate AD.

Fall risk factors in elderly patients with cognitive impairment on rehabilitation wards

2009 ◽  
Vol 9 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Michael Vassallo ◽  
Santhosh Kumar Mallela ◽  
Andrew Williams ◽  
Joseph Kwan ◽  
Steve Allen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Elderly Patients ◽  
Fall Risk ◽  
Fall Risk Factors

scholarly journals Efficacy of Controlled Whole-Body Vibration Training on Improving Fall Risk Factors in Stroke Survivors: A Meta-analysis

2020 ◽  
Vol 34 (4) ◽  
pp. 275-288 ◽  
Author(s):  
Feng Yang ◽  
Andrew J. Butler
Keyword(s):  
Risk Factors ◽  
Fall Risk ◽  
Whole Body Vibration ◽  
Functional Mobility ◽  
Whole Body ◽  
Body Balance ◽  
Body Vibration ◽  
Knee Strength ◽  
Fall Risk Factors ◽  
Strength Capacity

Background. Controlled whole-body vibration (CWBV) training has been applied to people with stroke. However, it remains inconclusive if CWBV reduces fall risk in this population. Objective. To (1) assess the immediate and retention effects of CWBV training on fall risk factors in people at postacute and chronic stages of stroke and (2) examine if CWBV dosage is correlated with the effect size (ES) for 3 fall risk factors: body balance, functional mobility, and knee strength. Methods. Twelve randomized controlled trials were included. ES was calculated as the standardized mean difference, and meta-analyses were completed using a random-effects model. Results. CWBV training may lead to improved balance and mobility immediately after training (ES = 0.27, P = .03 for balance; ES = 0.34, P = .02 for mobility) but not at the 3-month follow-up test (ES = 0.02, P = .89 for balance; ES = 0.70, P = .11 for mobility). CWBV affects knee strength capacity with mild ES (ES = 0.08 and 0.11, respectively, for immediate and retention effect; P ≥ .68 for both). Metaregression indicated that the immediate ES is strongly correlated with training dosage for balance ( r = 0.649; P = .029) and mobility ( r = 0.785; P = .036). Conclusions. CWBV training may benefit balance and mobility immediately, but the training effect may not persist among people with stroke. Additionally, the CWBV dosage correlates with the ES for body balance and mobility. More high-quality studies are needed to determine the retention effects of CWBV training.

Fall risk factors in older people with dementia or cognitive impairment: a systematic review

2009 ◽  
Vol 65 (5) ◽  
pp. 922-933 ◽  
Author(s):  
Jürgen Härlein ◽  
Theo Dassen ◽  
Ruud J. G. Halfens ◽  
Cornelia Heinze
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cognitive Impairment ◽  
Older People ◽  
Fall Risk ◽  
People With Dementia ◽  
Fall Risk Factors

scholarly journals Sleep Quality, Anxiety, and Depression Are Associated with Fall Risk Factors in Older Women

2020 ◽  
Vol 17 (11) ◽  
pp. 4043 ◽  
Author(s):  
Rodrigo Serrano-Checa ◽  
Fidel Hita-Contreras ◽  
José Daniel Jiménez-García ◽  
Alexander Achalandabaso-Ochoa ◽  
Agustín Aibar-Almazán ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sleep Quality ◽  
Older Women ◽  
Gait Speed ◽  
Fall Risk ◽  
Dynamic Balance ◽  
Community Dwelling ◽  
Functional Mobility ◽  
Anxiety And Depression ◽  
Fall Risk Factors

Gait, dynamic balance, and functional mobility problems are well-known fall risk factors. Furthermore, sleep disturbances, anxiety, and depression are prevalent among older women. This study aimed to analyze the associations of sleep quality, anxiety, and depression with functional mobility, gait speed, and dynamic balance in community-dwelling postmenopausal women aged ≥ 60 years. A total of 271 women (69.18 ± 5.69 years) participated in this study. Functional mobility (Timed Up-and-Go Test), dynamic balance (3-meter tandem walk test), gait speed (OptoGait® optical detection system), sleep quality (Pittsburgh Sleep Quality Index), and anxiety and depression (Hospital Anxiety and Depression Scale) were assessed. Our results showed that poor sleep efficiency and the use of sleeping medication were related to decreased gait speed (R2 = 0.072). Poor functional mobility was linked to depression and the use of sleeping medication (R2 = 0.159). Additionally, increased symptoms of anxiety and depression were associated with worsened dynamic balance (R2 = 0.127). In conclusion, poorer sleep quality is associated with slower gait speed and reduced functional mobility, which is also related, along with impaired dynamic balance, to higher levels of anxiety and depression.

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