Falls and Fall Prevention in Older Adults With Early-Stage Dementia: An Integrative Review

Abstract

Older adults with mild cognitive impairment (MCI) and early-stage dementia have an increased risk of falling, with risks to their health and quality of life. The purpose of the current integrative review was to evaluate evidence on fall risk and fall prevention in this population. Studies were included if they examined falls or fall risk factors in older adults with MCI or early-stage dementia, or reported interventions in this population; 40 studies met criteria. Evidence supports the increased risk of falls in individuals even in the early stages of dementia or MCI, and changes in gait, balance, and fear of falling that may be related to this increased fall risk. Interventions included exercise and multifactorial interventions that demonstrated some potential to reduce falls in this population. Few studies had strong designs to provide evidence for recommendations. Further study in this area is warranted. [Res Gerontol Nurs. 2017; 10(03):139-148.].

Toileting‐related falls at night in hospitalised patients: The role of nocturia

“…Lower urinary tract function is known to be altered in patients with dementia, with severe nocturia being reported in up to 84% of Lewy body dementia and white matter lesions, respectively . Evidence supports an increased risk of falls even in the early stages of dementia and confirms accompanying changes in gait, balance and fear of falling . Thus, older patients with dementia are highly likely to have night toileting needs, even in the absence of nocturnal polyuria.…”

“…21,22 Evidence supports an increased risk of falls even in the early stages of dementia and confirms accompanying changes in gait, balance and fear of falling. 23 Thus, older patients with dementia are highly likely to have night toileting needs, even in the absence of nocturnal polyuria.…”

Functional behaviour analysis guided interventions might improve transfer-related behaviour in dementia care dyads: a single case study

“…Caregiver burden and RTC are significantly related to poor outcomes with transfer-related daily activities in persons with dementia [9]. Intervention approaches have been mainly directed to mobility-related (physical) problems, which are managed via exercise programmes [10,11] or fall prevention programmes [12,13]. Psychosocial and environmental factors related to dementia disease, e.g.…”

Analysis of the risk and risk factors for injury in people with and without dementia: a 14-year, retrospective, matched cohort study

“…People with dementia were 1.076 times more likely to be hospitalized for accidental falls than were people without dementia. The recent literature and systematic reviews suggest that people with dementia are 2–8 times more likely to fall than are healthy individuals, with the former having an incidence of approximately 60–80% per year [ 15 , 16 , 37 – 40 ]. A prospective case-control study showed that elderly populations with cognitive impairment were two times more likely to fall than were those without cognitive impairment [ 41 ].…”

“…A prospective case-control study showed that elderly populations with cognitive impairment were two times more likely to fall than were those without cognitive impairment [ 41 ]. Even people with mild cognitive impairment (MCI) were at a higher risk of falls [ 40 ] and were 1.72 times more likely to fall than were those without cognitive impairment [ 42 ].…”