How Do Community-Dwelling Persons with Alzheimer Disease Fall? Falls in the FINALEX Study (original) (raw)
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Physiological Falls Risk Assessment in Older People with Alzheimer’s Disease
Dementia and Geriatric Cognitive Disorders, 2007
Older people with Alzheimer's disease (AD) experience a higher rate of falls and fall-related injury than cognitively intact older people . While the mechanisms contributing to falls in this group are poorly understood, there is some indication that physiological deficits may underlie this increased susceptibility . Physiological risk factors for falls, such as impaired vision [7] , slowed reaction time [8] and increased postural sway , are more pronounced in people with AD compared to controls, and people with AD exhibit significantly greater variability in gait patterns .
Physiological Falls Risk Assessment in Older People with Alzheimer’s Disease
Dementia and Geriatric Cognitive Disorders, 2007
Background: Falls are common in people with Alzheimer's disease (AD). There is some evidence that deficits in vision, peripheral sensation, strength, reaction time and balance may be partly responsible for this increased risk. Aims: To determine the feasibility and test-retest reliability of a physiological test battery designed to assess falls risk [the Physiological Profile Assessment (PPA)] in people with AD, and to compare their PPA scores to age-and sex-matched controls. Methods: Twenty-one community-dwelling people with probable, mild to moderate AD aged 63-91 years, and 21 age-and sex-matched controls underwent the PPA tests and the Mini-Mental State Examination. All tests were then repeated in the AD group to determine test-retest reliability. Results: Most of the PPA tests could be successfully administered to participants with AD. The AD group had a significantly higher overall falls risk score (t 40 =-2.41, p ! 0.02), slower hand (t 40 =-4.86, p ! 0.01) and foot reaction time (t 40 =-2.26, p ! 0.05) and worse coordinated stability (t 40 =-2.40, p ! 0.05) than the controls. Conclusion: Physiological falls risk assessment is feasible in older people with mild to moderate AD. Older people with AD demonstrate significant impairments in several physiological domains, particularly reaction time, compared to controls.
Risk Factors for Falls in Older Adults With Mild Cognitive Impairment and Mild Alzheimer Disease
Journal of geriatric physical therapy (2001), 2017
Understanding fall risk factors in people with mild cognitive impairment (MCI) and Alzheimer disease (AD) can help to establish specific plans for prevention of falls. The purpose of this study was to identify fall risk factors in older adults with MCI and mild AD. A prospective study was conducted with community-dwelling older adults (40 MCI; 38 mild AD). The assessments consisted of sociodemographic and health variables, caloric expenditure, functional status, functional mobility (10-m walk test, dual-task test, and transition Timed Up and Go phases), cognitive domains, and depressive symptoms. Falls were recorded for 6 months by a falls calendar and monthly telephone calls. Falls were reported in 52.6% and 51.4% of people with MCI and mild AD, respectively. Among people with MCI, lower functional status, higher time spent on walk and dual task tests, and higher depressive symptom scores were associated with falls. Higher time spent on the dual-task test was independently associat...
Characteristics of falls in mild and moderate Alzheimer's Disease
Dementia Neuropsychol, 2009
The occurrence of falls in AD patients is frequent, and their consequences are cognitive decline, fractures and loss of independence. Many studies have addressed fall risk factors in order to establish effective prevention strategies. Objectives: We describe the frequency and characteristics of falls in a sample of AD patients and their main risk factors. Methods: We evaluated 40 subjects without cognitive impairment, and 45 AD patients, graded as CDR 1 and CDR 2. Results: Environmental hazard risks were the most frequent cause associated with falls in CDR 1 (41.4%) and CDR 2 (46.7%). Instability (31%) and dizziness (17.2%) were frequent causes of falls in the CDR 1 group, and this group showed the highest rate of recurrence (28%). In both groups of AD patients, indoors falls predominated (70.3 and 80% respectively for CDR 1 and 2). In our sample, the remaining factors studied were not associated with increasing risk for falls. Conclusions: These results reinforce the hypothesis that falls in AD are mutifactorial and that their risk factors are highly interconnected. Preventative strategies considering all aspects should be implemented most crucially eliminating environmental risks, maintaining constant presence of caregivers, and providing physical and functional stimulation, both in mild and moderate AD.
Falls: a marker of preclinical Alzheimer disease: a cohort study protocol
BMJ Open, 2021
IntroductionProgression to symptomatic Alzheimer disease (AD) occurs slowly over a series of preclinical stages. Declining functional mobility may be an early indicator of loss of brain network integration and may lead to an increased risk of experiencing falls. It is unknown whether measures of functional mobility and falls are preclinical markers of AD. The purpose of this study is to examine (1) the relationship between falls and functional mobility with AD biomarkers to determine when falls occur within the temporal progression to symptomatic Alzheimer disease, and (2) the attentional compared with perceptual/motor systems that underlie falls and functional mobility changes seen with AD.Methods and analysisThis longitudinal cohort study will be conducted at the Knight Alzheimer Disease Research Center. Approximately 350 cognitively normal participants (with and without preclinical AD) will complete an in-home visit every year for 4 years. During each yearly assessment, functiona...
Archives of Gerontology and Geriatrics, 2008
People with dementia are at increased risk of falling. The purpose of this study was to identify predisposing risk factors for falls in older people with and without a diagnose of dementia living in residential care facilities, and to compare the results. Eighty-three residents without dementia (mean age AE S.D.; 83.5 AE 7.1 years) and 103 with dementia (83.6 AE 6.3 years) in Umeå, Sweden, participated. The baseline assessment included probable risk factors like walking ability, diagnoses and treatment with drugs. The follow-up period was 6 months. In people with dementia, the fall rate was higher (crude incidence rate ratio 2.55, 95% CI 1.60-4.08) and a larger proportion experienced falls (62% versus 41%). In the group without dementia 54.8% of the variation in falls was explained by a model including orthostatism, ''women walking with aid'', and treatment with Angiotensin Converting Enzyme (ACE) inhibitors. In the group with dementia 25.5% of the variation in falls was explained by a model including ''man walking with aid''. Our results show that with the same set of common risk factors for falls a considerably lower proportion of the variation in falls can be explained in the group of people with dementia. #
Influence of Alzheimer’s disease on the relationship between nutritional status and risk of fall
Acta Scientiarum. Health Sciences
Although malnutrition and risk of falls in the elderly have increased in recent years, uncertainties exist as to whether these conditions are associated after controlling for sociodemographic variables, body composition, metabolic condition, and Alzheimer’s disease (AD). This study aimed to analyze the association between nutritional status and risk of fall in the elderly population. Participants were matched by gender and age, after they had been grouped on the basis of diagnosis of AD. The risk of falls, nutritional status, and mental status were assessed using the Downton Fall Risk Score (FRS), Mini Nutritional Assessment (MNA), and Mini Mental State Evaluation (MMSE), respectively. Logistic regression models adjusted for the main confounders were used in the analyses. Among the 68 elderly individuals studied, participants who were malnourished or at risk of malnutrition were more likely to fall (odds ratio = 8.29; 95% confidence interval = 1.49-46.04) than those with normal nutr...
Prevalence of Falls and Fractures in Alzheimer’s Patients Compared to General Population
Cureus, 2021
Introduction Alzheimer's disease (AD), found in the aging elderly population, is a progressive neurodegenerative disorder that leads to worsening memory loss and cognitive impairment. Falls and fractures are common in the overall elderly population. Hence, the purpose of this study is to determine the prevalence of falls and fractures in Alzheimer's patients compared to the general population. Methodology This longitudinal study was conducted at the neurology outpatient department (OPD) in a tertiary healthcare setup in Pakistan from November 2019 till April 2020. Previously confirmed diagnosed Alzheimer's patients from neurology OPD were included in one group. Equal number of gender and agematched healthy participants were included in the reference group. Participants were followed for 12 months to determine the incidence of falls and non-vertebral fractures. Results The incidence of fall was significant in the Alzheimer group compared to the reference group (22.8% vs. 10.9%; relative risk (RR): 2.08; P-value: 0.01). Fractures were also significantly more common in the Alzheimer group compared to the reference group (12.8% vs. 5.1%; RR: 2.51; P-value: 0.03). Conclusion This study demonstrated a higher incidence of falls and fractures in Alzheimer's patients compared to healthy non-Alzheimer individuals. Management of AD should include measures to reduce falls and fractures in addition to standard therapy.
Falls Risk and Alzheimer Disease: A Patient Guide
Archives of Physical Medicine and Rehabilitation, 2020
Alzheimer disease is a common brain disorder in older adults that affects memory, thinking, and behavior. The symptoms usually develop slowly but become worse with time and can affect your day-today activities. 1 Am I at higher risk of falling after a diagnosis of Alzheimer disease? Yes, you may be at higher risk of falling after a diagnosis of Alzheimer disease. 2 Why am I at higher risk of falling if I have Alzheimer disease? Alzheimer disease can affect your ability to make decisions or to organize your thoughts while performing your day-today activities. Also, due to Alzheimer disease, you might have trouble identifying and avoiding objects on the floor. These difficulties increase the risk of fall. 3 How can falls harm me? Falls can be dangerous and lead to injury and hospitalization. Fear of falling can make you scared of moving around or performing your day-today activities. When you move less, you get weaker and frailer, and you may need more help from others. 2 When your body gets weaker, you are at higher risk of falling and getting hurt.