Characteristics associated with falls in patients with dementia in a psychogeriatric ward

Abstract

Few studies have reported fall-risk factors for persons with dementia, and no successful randomized fall prevention studies have been published. The aim of this study was to identify characteristics associated with falls in patients with dementia in a psychogeriatric ward. This prospective study comprised 204 patients with any diagnosis of dementia. It was carried out in a psychogeriatric ward specializing in the assessment and treatment of behavioral and psychological symptoms in patients with dementia (BPSD). Baseline patient data were collected from medical records, and covered physical, behavioral and cognitive areas. Falls were recorded during time spent in the ward and median follow-up time was 52.5 days. Eighty-two patients fell a total of 251 times. Factors significantly and independently associated with an increased risk of falling were male sex (IRR 3.36, 95% CI 2.02-5.61), failed "copy design" activity (decreased visual perception) (IRR 2.37, 95% CI 1.24-4.52), and any walking difficulty on level ground (IRR 1.84, 95% CI 1.10-3.08). Statins were associated with a decreased risk of falling (IRR 0.29, 95% CI 0.10-0.86). Twenty-seven percent of the variation in falls was explained. Male sex, decreased visual perception, and walking difficulties were all associated with an increased number of falls, and the model explained 1/4 of the variation in falls. Well-planned furnishing and use of color to achieve a plain, clearly defined environment, as well as training in walking ability, may decrease the risk of falling in people with dementia.