Abstract
Introduction: Falls in psychogeriatric residents represent a costly but unresolved safety issue. Identifying fall risk factors and their inter-relationship may help to individualize prevention programs and increase the effectiveness. Therefore, we aimed to examine the relationship between patient characteristics and fall rate in psychogeriatric residents. Methods: Twenty nursing home residents with dementia (80±11 years; 60% male) living on a psychogeriatric ward participated. Based on patient records, we identified 66 patient characteristics and extracted the number of falls over 19 months. Patient characteristics represented seven domains: demographics, ADL, mobility, cognition and behaviour, vision and hearing, medical conditions, and drug-use. We evaluated the relationship between patient characteristics and fall rate using multivariate Partial Least Squares regression. Results: A total of 115 falls (5.1±6.7 falls/person year) occurred during the study period. The 66 patient characteristics included in the model explained 96% of the variance in fall rate. Reduced mobility abilities, indicators of disinhibited behavior, diabetes, and use of analgesics, beta blocking agents and psycholeptics were positively associated with fall rate. Whereas immobility, heart failure, and the inability to communicate were negatively associated fall rate. Conclusion: Dementia is often indicated as fall risk factor; however, our results showed that especially cognitive impairment related to disinhibited behaviour was associated with a high fall rate in psychogeriatric residents. Furthermore, immobility and inactivity seemed to decrease fall rate. The analytic approach provided a detailed view of the fall risk factors and their interactions in psychogeriatric residents, enabling more effective fall prevention.
Published Version
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