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

Abstract

Background: Confusion and cognitive impairment, are risk factors for falls in hospital. Evidence for reducing falls in cognitively-impaired patients is limited and to date no intervention has consistently been shown to reduce falls in this group of patients. We explored characteristics associated with falls in cognitively-impaired patients in a rehabilitation setting. Methods:In a prospective observational study, 825 consecutive patients were studied. Patient characteristics were assessed on admission. Factors predisposing to falls in cognitively-impaired patients were identified. Results:Cognitively-impaired patients were more likely to be fallers or recurrent fallers and more likely to sustain an injury than cognitively intact patients. They had a higher incidence of nursing home discharges and a significantly higher mortality. Logistic regression analysis showed that an unsafe gait (P < 0.001; 95% confidence interval, 0.13-0.57) was the only independent risk factor for falls in this group of patients. There was a cumulative higher risk of falling associated with an unsafe gait demonstrable throughout the patients' stay. Conclusion:Unsafe gait was the only significant independent risk factor for falls among cognitively-impaired patients in a rehabilitation environment. Interventions that improve gait patterns or that enhance safety for patients with abnormal gait are required if fall reduction in this group of patients is to be achieved.

Effectiveness of Interventions to Prevent Falls in People With Alzheimer’s Disease and Related Dementias

“…Significant fall predictors for people with AD or other dementias include diagnosis of Lewy body disorder, a history of falls or recurrent falls in the previous 12 mo, symptomatic orthostatic hypotension, abnormal gait or balance score, impaired vision, and depression score (Allan et al, 2009;Harlein, Dassen, Halfens, & Heinze, 2009;Vassallo et al, 2009). Increased levels of physical activity and younger age have been reported to be protective factors against falls for people with AD (Allan et al, 2009).…”

Efectividad de las intervenciones para la prevención de caídas en ancianos: revisión sistemática

“…Los estudios proponen y utilizan la rehabilitación, pero sigue siendo un reto que se complica con la medicación, factor importante del origen de éstas (43,57), pero pueden reducirlas mediante la gestión de la hipotensión ortostática, la depresión y el fomento de la actividad física (41). Investigar sobre un programa multifactorial que contenga diversas intervenciones puede reducirlas y prevenirlas (52,58).…”

Proprioceptive evaluation in healthy women undergoing Infrared Low Level Laser Therapy

“…One of the most important parameters to the LLLT is the wavelength, which can determine the depth of penetration and absorption, thus their effects. Since longer wavelengths are absorbed into the deeper layers of biological tissue 31 , and in the present study the aim was to reach the muscle tissue by stimulating the proprioceptive components 2,3,6 , it was chosen infrared 830 nm wavelength. Similar to the wavelength used by Almeida et al 32 , comparing the 830 nm to 660 nm, but found that both wavelengths promoted increased peak power and delayed fatigue of the biceps muscle.…”