Incidence and prediction of falls in dementia: a prospective study in older people.

<h4>Background</h4>Falls are a major cause of morbidity and mortality in dementia, but there have been no prospective studies of risk factors for falling specific to this patient population, and no successful falls intervention/prevention trials. This prospective study aimed to identify...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Louise M Allan, Clive G Ballard, Elise N Rowan, Rose Anne Kenny
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2009
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c372f67820884a73bb4fe1ac70211c7f
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:c372f67820884a73bb4fe1ac70211c7f
record_format	dspace
spelling	oai:doaj.org-article:c372f67820884a73bb4fe1ac70211c7f2021-12-02T20:12:12ZIncidence and prediction of falls in dementia: a prospective study in older people.1932-620310.1371/journal.pone.0005521https://doaj.org/article/c372f67820884a73bb4fe1ac70211c7f2009-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19436724/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Falls are a major cause of morbidity and mortality in dementia, but there have been no prospective studies of risk factors for falling specific to this patient population, and no successful falls intervention/prevention trials. This prospective study aimed to identify modifiable risk factors for falling in older people with mild to moderate dementia.<h4>Methods and findings</h4>179 participants aged over 65 years were recruited from outpatient clinics in the UK (38 Alzheimer's disease (AD), 32 Vascular dementia (VAD), 30 Dementia with Lewy bodies (DLB), 40 Parkinson's disease with dementia (PDD), 39 healthy controls). A multifactorial assessment of baseline risk factors was performed and fall diaries were completed prospectively for 12 months. Dementia participants experienced nearly 8 times more incident falls (9118/1000 person-years) than controls (1023/1000 person-years; incidence density ratio: 7.58, 3.11-18.5). In dementia, significant univariate predictors of sustaining at least one fall included diagnosis of Lewy body disorder (proportional hazard ratio (HR) adjusted for age and sex: 3.33, 2.11-5.26), and history of falls in the preceding 12 months (HR: 2.52, 1.52-4.17). In multivariate analyses, significant potentially modifiable predictors were symptomatic orthostatic hypotension (HR: 2.13, 1.19-3.80), autonomic symptom score (HR per point 0-36: 1.055, 1.012-1.099), and Cornell depression score (HR per point 0-40: 1.053, 1.01-1.099). Higher levels of physical activity were protective (HR per point 0-9: 0.827, 0.716-0.956).<h4>Conclusions</h4>The management of symptomatic orthostatic hypotension, autonomic symptoms and depression, and the encouragement of physical activity may provide the core elements for the most fruitful strategy to reduce falls in people with dementia. Randomised controlled trials to assess such a strategy are a priority.Louise M AllanClive G BallardElise N RowanRose Anne KennyPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 4, Iss 5, p e5521 (2009)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Louise M Allan Clive G Ballard Elise N Rowan Rose Anne Kenny Incidence and prediction of falls in dementia: a prospective study in older people.
description	<h4>Background</h4>Falls are a major cause of morbidity and mortality in dementia, but there have been no prospective studies of risk factors for falling specific to this patient population, and no successful falls intervention/prevention trials. This prospective study aimed to identify modifiable risk factors for falling in older people with mild to moderate dementia.<h4>Methods and findings</h4>179 participants aged over 65 years were recruited from outpatient clinics in the UK (38 Alzheimer's disease (AD), 32 Vascular dementia (VAD), 30 Dementia with Lewy bodies (DLB), 40 Parkinson's disease with dementia (PDD), 39 healthy controls). A multifactorial assessment of baseline risk factors was performed and fall diaries were completed prospectively for 12 months. Dementia participants experienced nearly 8 times more incident falls (9118/1000 person-years) than controls (1023/1000 person-years; incidence density ratio: 7.58, 3.11-18.5). In dementia, significant univariate predictors of sustaining at least one fall included diagnosis of Lewy body disorder (proportional hazard ratio (HR) adjusted for age and sex: 3.33, 2.11-5.26), and history of falls in the preceding 12 months (HR: 2.52, 1.52-4.17). In multivariate analyses, significant potentially modifiable predictors were symptomatic orthostatic hypotension (HR: 2.13, 1.19-3.80), autonomic symptom score (HR per point 0-36: 1.055, 1.012-1.099), and Cornell depression score (HR per point 0-40: 1.053, 1.01-1.099). Higher levels of physical activity were protective (HR per point 0-9: 0.827, 0.716-0.956).<h4>Conclusions</h4>The management of symptomatic orthostatic hypotension, autonomic symptoms and depression, and the encouragement of physical activity may provide the core elements for the most fruitful strategy to reduce falls in people with dementia. Randomised controlled trials to assess such a strategy are a priority.
format	article
author	Louise M Allan Clive G Ballard Elise N Rowan Rose Anne Kenny
author_facet	Louise M Allan Clive G Ballard Elise N Rowan Rose Anne Kenny
author_sort	Louise M Allan
title	Incidence and prediction of falls in dementia: a prospective study in older people.
title_short	Incidence and prediction of falls in dementia: a prospective study in older people.
title_full	Incidence and prediction of falls in dementia: a prospective study in older people.
title_fullStr	Incidence and prediction of falls in dementia: a prospective study in older people.
title_full_unstemmed	Incidence and prediction of falls in dementia: a prospective study in older people.
title_sort	incidence and prediction of falls in dementia: a prospective study in older people.
publisher	Public Library of Science (PLoS)
publishDate	2009
url	https://doaj.org/article/c372f67820884a73bb4fe1ac70211c7f
work_keys_str_mv	AT louisemallan incidenceandpredictionoffallsindementiaaprospectivestudyinolderpeople AT clivegballard incidenceandpredictionoffallsindementiaaprospectivestudyinolderpeople AT elisenrowan incidenceandpredictionoffallsindementiaaprospectivestudyinolderpeople AT roseannekenny incidenceandpredictionoffallsindementiaaprospectivestudyinolderpeople
_version_	1718374907670167552

Incidence and prediction of falls in dementia: a prospective study in older people.

Ejemplares similares