The development of a multidisciplinary fall risk evaluation tool for demented nursing home patients in the Netherlands

Neyens, J.C.L.; Dijcks, B.; Haastregt, Jolanda C. M. van; Witte, Luc de; Heuvel, W.J.A. van den; Crebolder, H. F. J. M.; Schols, Jos M. G. A.

doi:10.1186/1471-2458-6-74

Cited by 35 publications

(32 citation statements)

References 55 publications

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“…We also found evidence to suggest that multifactorial interventions which included exercise can be effective in older people with cognitive impairment and depression, with four of six studies finding a reduction in falls which was significant in two [40,48] although there is insufficient evidence to support physical activity or exercise alone with this population.…”

Section: Discussionmentioning

confidence: 93%

Preventing falls among older people with mental health problems: a systematic review

et al. 2014

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BackgroundFalls are a leading cause of mortality and morbidity in older people and the risk of falling is exacerbated by mental health conditions. Existing reviews have focused on people with dementia and cognitive impairment, but not those with other mental health conditions or in mental health settings. The objective of this review is to evaluate the effectiveness of fall prevention interventions for older people with mental health problems being cared for across all settings.MethodsA systematic review of fall prevention interventions for older people with mental health conditions. We undertook electronic database and lateral searches to identify studies reporting data on falls or fall related injuries. Searches were initially conducted in February 2011 and updated in November 2012 and October 2013; no date restrictions were applied. Studies were assessed for risk of bias. Due to heterogeneity results were not pooled but are reported narratively.ResultsSeventeen RCTs and four uncontrolled studies met the inclusion criteria; 11 involved single interventions and ten multifactorial. Evidence relating to fall reduction was inconsistent. Eight of 14 studies found a reduction in fallers (statistically significant in five), and nine of 14 reported a significant reduction in rate or number of falls. Four studies found a non-significant increase in falls. Multifactorial, multi-disciplinary interventions and those involving exercise, medication review and increasing staff awareness appear to reduce the risk of falls but evidence is mixed and study quality varied. Changes to the environment such as increased supervision or sensory stimulation to reduce agitation may be promising for people with dementia but further evaluation is needed. Most of the studies were undertaken in nursing and residential homes, and none in mental health hospital settings.ConclusionsThere is a dearth of falls research in mental health settings or which focus on patients with mental health problems despite the high number of falls experienced by this population group. This review highlights the lack of robust evidence to support practitioners to implement practices that prevent people with mental health problems from falling.

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Section: Discussionmentioning

confidence: 93%

Preventing falls among older people with mental health problems: a systematic review

et al. 2014

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“…The results show that the functions of mobility (including standing still, walking, activities of daily living) can be successfully used to assess fall risk. Among them, Barthel index was confirmed to be good tool of measuring daily living [11].…”

Section: B Research Methodsmentioning

confidence: 99%

Elderly inpatient fall risk factors: A study of decision tree and logistic regression

Chan¹,

Chen²,

Chiu³

2010

The 40th International Conference on Computers &Amp; Indutrial Engineering

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The elderly fall events have become the major public health issue in the world these days. In the United States, falls are the leading cause of accidental death for the elderly. This study applied logistic regression and decision tree to construct inpatient fall risk assessment model in elderly patients. By case-control method, we collected 602 fall and non-fall patients' data, including demographic variables, physiological variables, Barthel indexes, hospitalization risk factors for falls from a regional teaching hospital in northern Taiwan. The result shows six important variables: 1. whether the patient has fallen in the past year 2. cognitive problems, disorientation, irritability during hospitalization 3. movement responses 4. dizziness during hospitalization 5. unsteady gait and use of walking aids during hospitalization and 6. length of stay. For surgical patients, the ways of emergency admission were significantly related to patient fall. A new risk factor -movement response is also significant to predict the elderly inpatient falls. A patient would have a high risk of fall if his/her movement response score is less than six points. The accuracy of fall prediction with training data and validation data are both 70%. The findings provide suggestions for nursing department to identify the high-risk patients and to take preventive measures when they are admitted into hospital.

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“…A number of risk factors for falls have been described in the literature 6,8,[18][19][20][21][22] . Aside from risk factors regarding physical performance, fall risk factors that were assessed in this study include low body mass index, dizziness or vertigo, osteoarthritis, arrhythmia, depression, visual disturbance, hypotension, use of antihypertensive drugs, sedatives or hypnotics, or antidepressants, and use of four or more medications [18][19][20][21] .…”

Section: Assessment Of Other Fall Risk Factorsmentioning

confidence: 99%

“…Aside from risk factors regarding physical performance, fall risk factors that were assessed in this study include low body mass index, dizziness or vertigo, osteoarthritis, arrhythmia, depression, visual disturbance, hypotension, use of antihypertensive drugs, sedatives or hypnotics, or antidepressants, and use of four or more medications [18][19][20][21] . Subjects with a history of fragility fractures, which has been consistently identified as an isolated risk factor of distal radial fracture 6,8,22 , were excluded from this study as we excluded those with a history of distal radial fracture from the control group.…”

Section: Assessment Of Other Fall Risk Factorsmentioning

confidence: 99%

Evaluation of Physical Performance Level as a Fall Risk Factor in Women with a Distal Radial Fracture

Cho

Gong

Song

et al. 2014

Journal of Bone and Joint Surgery

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The development of a multidisciplinary fall risk evaluation tool for demented nursing home patients in the Netherlands

Cited by 35 publications

References 55 publications

Preventing falls among older people with mental health problems: a systematic review

Preventing falls among older people with mental health problems: a systematic review

Elderly inpatient fall risk factors: A study of decision tree and logistic regression

Evaluation of Physical Performance Level as a Fall Risk Factor in Women with a Distal Radial Fracture

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