Risk factors for falls in older adults with cognitive impairment

Mamta Saini, M. Subramanian, N. Soni, Vishwajeet Singh, A. Chakrawarty, P. Chatterjee, A. Dey
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Abstract

Background: Falls are one of the leading causes of disability among older people. The risk factors of falls widely vary among the older populations, including the different stages of cognitive impairment. We aim to identify the risk factors for falls among cognitively impaired older adults. Materials and Methods: In a cross-sectional study, older adults attending the memory clinic were screened for falls and their risk factors. A total of 112 subjects who satisfied the inclusion criteria and provided informed consent were subjected to a semi-structured interview and comprehensive geriatric assessment. Cognitive impairment was graded by the Clinical Dementia Rating (CDR). Subjects were divided into fallers and nonfallers. A multivariable logistic regression analysis was done to identify the independent risk factors of falls. Results: The prevalence of falls was 39.28% in the study population. Gender (adjusted odds ratio [aOR] [95% confidence interval (CI)]: 2.21 [0.690–7.117]), body mass index (aOR [95% CI]: 0.89 [0.773–1.028]), socioeconomic status (middle-class aOR [95% CI]: 0.34 [0.077–1.526], lower-class aOR [95% CI]: 2.44 [0.349–17.160]), multimorbidity (aOR [95% CI]: 19.39 [1.043–360.373]), depression (mild aOR [95% CI]: 2.90 [0.896–9.429] and moderate aOR [95% CI]: 4.77 [0.967–23.597]), and impairment in hobbies and home (aOR [95% CI]: 24.78 [6.251–98.294]) part of CDR were the independent predictors of falls. Conclusion: Older adults with cognitive impairment are at high risk of falling with definitive risk factors. Regular screening will help to identify older adults at risk of falls and enable fall prevention to reduce morbidity and dependency.
认知障碍老年人跌倒的危险因素
背景:跌倒是老年人致残的主要原因之一。老年人跌倒的危险因素差别很大,包括认知障碍的不同阶段。我们的目的是确定认知受损的老年人跌倒的危险因素。材料和方法:在一项横断面研究中,对参加记忆诊所的老年人进行了跌倒及其危险因素的筛查。总共112名符合纳入标准并提供知情同意的受试者接受了半结构化访谈和综合老年病学评估。通过临床痴呆评分(CDR)对认知障碍进行评分。研究对象被分为跌倒者和非跌倒者。采用多变量logistic回归分析确定跌倒的独立危险因素。结果:研究人群跌倒发生率为39.28%。性别(调整比值比[aOR][95%可信区间(CI)]: 2.21[0.690-7.117])、体重指数(aOR [95% CI]: 0.89[0.773-1.028])、社会经济地位(中产阶级aOR [95% CI]: 0.34[0.077-1.526]、下层aOR [95% CI]: 2.44[0.349-17.160])、多发病(aOR [95% CI]: 19.39[1.043-360.373])、抑郁症(轻度aOR [95% CI]: 2.90[0.896-9.429]、中度aOR [95% CI]: 4.77[0.967-23.597])、爱好和家庭障碍(aOR [95% CI]: 2.21 [0.690-7.117]):24.78[6.251-98.294])是跌倒的独立预测因子。结论:老年认知障碍患者有明显的跌倒危险因素。定期筛查将有助于识别有跌倒风险的老年人,并使预防跌倒成为可能,以减少发病率和依赖性。
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