Factors associated with falls among hospitalized and community-dwelling older adults: the APPCARE study

Bally, Esmee LS; Ye, Lizhen; Grieken, Amy van; Tan, Siok Swan; Mattace-Raso, Francesco; Procaccini, Elena; Alhambra‐Borrás, Tamara; Raat, Hein

doi:10.3389/fpubh.2023.1180914

Cited by 4 publications

(4 citation statements)

References 40 publications

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“…It was found that women had an increased risk of experiencing falls compared to men, which aligned with the conclusions drawn in previous studies ( 18 , 32 , 34 ). In addition, significant factors inversely associated with falls include: advanced age, mild to moderate of disability, and ranging from acceptable to poor sleep quality.…”

Section: Discussionsupporting

confidence: 90%

A study on the falls factors among the older adult with cognitive impairment based on large-sample data

Wang,

Zhang,

Wang

et al. 2024

Front. Public Health

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IntroductionThis study explored the correlative factors of falls among the older adult with cognitive impairment, to provide distinct evidence for preventing falls in the older adult with cognitive impairment compared with the general older adult population.MethodsThis study was based on a cross-sectional survey, with an older adult population of 124,124 was included. The data was sourced from the Elderly Care Unified Needs Assessment for Long-Term Care Insurance in Shanghai. Binary and multivariable logistic regression analyses were conducted sequentially on the correlative factors of falls. Multivariable logistic regression was performed on variables that were significant, stratified by cognitive function levels.ResultsThe incidence of fall in the past 90 days was 17.67% in this study. Specific variables such as gender (male), advanced age (≥80), residence with a elevator (or lift), mild or moderate disability, quality of sleep (acceptable/poor) were negatively correlated with falls, while higher education level, living alone, residence with indoor steps, unclean and untidy living environment, MCI or dementia, chronic diseases, restricted joints, impaired vision, and the use of diaper were positively correlative factors of falls. Comparing with older adult with normal cognitive functions, older adult with dementia faced a higher risk of falling due to accessibility barrier in the residence. For general older adults, less frequency of going outside and poor social interactions were positively correlated with falls, while for older adult with cognitive impairments, going outside moderately (sometimes) was found positively correlated with falls. Older adults with cognitive impairments have increased fall risks associated with chronic diseases, restricted joints, and the use of diaper. The risk of falling escalated with the greater number of chronic diseases.DiscussionFor older adult with cognitive impairments, it is advisable to live with others. Additionally, creating an accessible living environment and maintaining the cleanness and tidiness can effectively reduce the risk of falls, particularly for those with MCI or dementia. Optimal outdoor activity plans should be developed separately based on the cognitive function of older adults. Older adult with dementia who have comorbidities should be paid special attention in fall prevention compared to the general older adult population.

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Section: Discussionsupporting

confidence: 90%

A study on the falls factors among the older adult with cognitive impairment based on large-sample data

Wang,

Zhang,

Wang

et al. 2024

Front. Public Health

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“…These conditions could be managed adequately by care providers. Our study cohort was older residents in a long-term facility who reported insignificant factors for falls, including level of education [6], length of residency [27], depression [2], and past fall experience [24,27].…”

Section: Discussionmentioning

confidence: 99%

Incidence and Factors Associated with Falls in Older People in a Long-Term Care Facility: A Prospective Study in Taiwan

Lee,

Hsieh,

Jerng

2024

Healthcare

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Background: The effectiveness of applying a fall-risk assessment to prevent falls in residents of long-term care facilities has not been investigated. Methods: This prospective study enrolled elderly residents in a long-term care facility in Taiwan. Caregivers were provided with a health-status assessment and fall-risk data to enhance their fall-prevention practices. A multivariate analysis was performed to identify the factors associated with falls. Results: A total of 123 subjects, including 68 and 55 for general and nursing-care models, respectively, were assessed. Their health status and risk of falls were provided to the care units to enhance their fall-prevention practices. Subjects in the nursing-care model had more dementia and more prescribed medications, worse physiologic conditions, and higher fall risk. Of them, 28 (23%) had subsequent falls. A univariate analysis showed that those with and without falls were similar in demographic characteristics, prescribed medications, physiologic function, and fall risk. There was a tendency for more falls in the nursing-care model residents (accounting for 61% of those who fell; p = 0.053). A regression analysis showed that gender (beta = 1.359; 95% confidence interval = 0.345–2.374; p = 0.010) and NPI score (beta = 0.101; 95% CI = 0.001–0.200; p = 0.047) were associated with the risk of falls. Conclusion: Residents at the long-term care facility had a significant risk of falls despite knowledge of their fall risk and the implementation of preventive measures. In this context of being aware of the risk, gender, and psychiatric symptoms were significantly associated with falls. Caregivers at long-term care facilities should implement further measures to prevent falls based on behavioral and psychological symptoms.

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“…[80][81][82] Moreover, in addition to prioritizing fall prevention within healthcare organizations, future research endeavors could concentrate on extending fall prevention initiatives to the community level. 83,84 Implementing measures such as public education and the establishment of community support networks can effectively enhance fall awareness and prevention among older adults residing in the community. Furthermore, aggressive treatment of CKD-related complications, such as arthritis and neurological disorders, can help reduce falls.…”

Section: Othersmentioning

confidence: 99%

Involuntary Falls in Patients with Chronic Kidney Diseases on Nephrology Wards: Research Advances and Future Perspectives

Liao,

Wang,

Sui

et al. 2024

NRR

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Background: Nephrology nursing faces an inevitable challenge when it comes to falls. This study aims to review existing literature on falls in chronic kidney disease (CKD) patients and to discuss potential solutions. Methods: This review explores the characteristics and causes of falls in CKD patients, elucidate the underlying mechanisms, shares better nursing practices, and discusses both current prevention strategies as well as potential future interventions. Results: CKD patients often experience consciousness impairment and motor dysfunction due to factors such as muscle atrophy, nerve damage, malnutrition, anemia, fluid-electrolyte imbalances, hormonal disorders, and dialysis. Additionally, this study not only shares insights from nursing experience with these patients, but also reviews current evidence-based fall prevention strategies and proposes potential new interventions that could be tested in future research. Conclusion: CKD may increase the risk of involuntary falls in patients due to consciousness impairment and motor dysfunction. Advocating for a standardized expert consensus on fall risk assessment and comprehensive care for CKD patients would enhance the nursing framework in nephrology wards and help patients decrease their fall risk and elevate their quality of life.

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Factors associated with falls among hospitalized and community-dwelling older adults: the APPCARE study

Cited by 4 publications

References 40 publications

A study on the falls factors among the older adult with cognitive impairment based on large-sample data

A study on the falls factors among the older adult with cognitive impairment based on large-sample data

Incidence and Factors Associated with Falls in Older People in a Long-Term Care Facility: A Prospective Study in Taiwan

Involuntary Falls in Patients with Chronic Kidney Diseases on Nephrology Wards: Research Advances and Future Perspectives

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