Dementia as a risk factor for falls and fall injuries among nursing home residents
Dementia as a risk factor for falls and fall injuries among nursing home residents
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DOI：
10.1046/j.1532-5415.2003.51404.x
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发表时间：
2003-09-01
影响因子：
6.3
通讯作者：
Magaziner, J
中科院分区：
文献类型：
--
作者：
van Doorn, C;Gruber-Baldini, AL;Magaziner, J
目的：比较老年痴呆症患者和非老年痴呆症患者之间的跌倒率，并检查痴呆作为跌倒和跌倒损伤的独立危险因素。设计：前瞻性队列研究，随访2年。环境：在马里兰州随机选择59家养老院，按地理区域和设施规模分层。参与者：65岁及以上的新住院居民25,15人。测量：在养老院入院后的2年内，从养老院图表和出院摘要中收集跌倒数据。结果：痴呆症患者在养老院的未调整跌倒率为每年4.05次，而非痴呆症患者的未调整跌倒率为每年2.33次（P < 0.0001）。当考虑到已知的风险因素时，痴呆症对跌倒率的影响仍然存在。在跌倒事件中，那些发生在痴呆症居民身上的跌倒并不比没有痴呆症的居民更容易导致受伤，但是，鉴于痴呆症居民的跌倒率明显更高，他们受伤的跌倒率高于没有痴呆症的居民。结论：痴呆是跌倒的独立危险因素。虽然大多数跌倒并不会导致受伤，但事实上，痴呆症患者比没有痴呆症的人更经常跌倒，这使得他们随着时间的推移，持续跌倒的总体风险更高。老年痴呆症患者应被视为预防跌倒和预防跌倒损伤策略的重要候选人。
OBJECTIVES: To compare rates of falling between nursing home residents with and without dementia and to examine dementia as an independent risk factor for falls and fall injuries.DESIGN: Prospective cohort study with 2 years of follow-up.SETTING: Fifty-nine randomly selected nursing homes in Maryland, stratified by geographic region and facility size.PARTICIPANTS: Two thousand, fifteen newly admitted residents aged 65 and older.MEASUREMENTS: During 2 years after nursing home admission, fall data were collected from nursing home charts and hospital discharge summaries.RESULTS: The unadjusted fall rate for residents in the nursing home with dementia was 4.05 per year, compared with 2.33 falls per year for residents without dementia (P < .0001). The effect of dementia on the rate of falling persisted when known risk factors were taken into account. Among fall events, those occurring to residents with dementia were no more likely to result in injury than falls of residents without dementia, but, given the markedly higher rates of falling by residents with dementia, their rate of injurious falls was higher than for residents without dementia.CONCLUSION: Dementia is an independent risk factor for falling. Although most falls do not result in injury, the fact that residents with dementia fall more often than their counterparts without dementia leaves them with a higher overall risk of sustaining injurious falls over time. Nursing home residents with dementia should be considered important candidates for fall-prevention and fall-injury-prevention strategies.