Fall determinants in older long-term care residents with dementia: a systematic review

Kröpelin, Tobias F.; Neyens, J.C.L.; Halfens, Ruud J.G.; Kempen, Gertrudis I. J. M.; Hamers, Jan P.H.

doi:10.1017/s1041610212001937

Cited by 49 publications

(38 citation statements)

References 39 publications

(81 reference statements)

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“…Our findings align with outcomes of previous reviews examining fall prediction in healthy older adults [28,40], and provide important additions to the literature by (1) focusing on dementia populations, (2) examining both instrumented and non-instrumented measures of gait and balance, and (3) focusing on falls as the outcome measure. Our findings support the growing body of evidence regarding the effectiveness of mobility assessment in identifying individuals with dementia at high risk for falls [12,26,29,31,32,34,36,38].…”

Section: Discussionsupporting

confidence: 82%

Quantitative Mobility Assessment for Fall Risk Prediction in Dementia: A Systematic Review

Dolatabadi

Ooteghem

Taati

et al. 2018

Dement Geriatr Cogn Disord

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Background: Impairments of gait and balance often progress through the course of dementia, and are associated with increased risk of falls. Summary: This systematic review provides a critical analysis of the evidence linking quantitative measures of gait and balance to fall risk in older adults with dementia. Various instrumented measures of gait and postural stability including gait speed and non-instrumented performance measures including Timed Up and Go were shown to be capable of distinguishing fallers from non-fallers. Key Messages: Existing reviews indicate that impairments of gait and balance are associated with increased risk of falls in cognitively intact older people. There are inconsistencies, however, regarding the characteristics most predictive of a fall. In order to advance fall prevention efforts, there is an important need to understand the relationship between gait, balance, and fall risk, particularly in high-risk populations such as individuals with dementia.

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Section: Discussionsupporting

confidence: 82%

Quantitative Mobility Assessment for Fall Risk Prediction in Dementia: A Systematic Review

Dolatabadi

Ooteghem

Taati

et al. 2018

Dement Geriatr Cogn Disord

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“…The presence or absence of a comorbid health condition obtained from any hospital admission up to 5 years before and including the index hospital admission was used in this analysis. A previous history of falls was included as a covariate because previous research has shown that it increases risk of a future fall . Information on length of hospital stay was also collected.…”

Section: Methodsmentioning

confidence: 99%

“…A previous history of falls was included as a covariate because previous research has shown that it increases risk of a future fall. 7 Information on length of hospital stay was also collected. An injury event was classified as major trauma if the participant had an Injury Severity Score (ISS) greater than 15 and as minor trauma if the ISS was 15 or less.…”

Section: Outcome Of Interestmentioning

confidence: 99%

A Population‐Based Study Examining Injury in Older Adults with and without Dementia

Meuleners

Hobday

2017

J American Geriatrics Society

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“…These findings reveal that gait is more than just an automatic behavior: rather gait requires attention and input from multiple structures within the central nervous system. Previous systematic reviews have certainly emphasized the importance of impaired gait as a falls risk factor (Harlein et al, 2009;Kropelin et al, 2013;Fernando et al, 2017), however, to the authors' knowledge, no systematic review has summarized the specifics and details of this factor in the estimation of risk for people with dementia. This type of review is necessary in order to give meaning to the concept of gait impairment as a fall risk factor in people with dementia and, knowledge translation to the clinical practice of what is relevant to assess and to develop and evaluate fall prevention strategies directed at the specific deficits.…”

mentioning

confidence: 99%

Gait parameters and characteristics associated with increased risk of falls in people with dementia: a systematic review

Modarresi

Divine

Grahn

et al. 2018

Int. Psychogeriatr.

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Background: People with dementia fall twice as often and have more serious fall-related injuries than healthy older adults. While gait impairment as a generic term is understood as a fall risk factor in this population, a clear elaboration of the specific components of gait that are associated with falls risk is needed for knowledge translation to clinical practice and the development of fall prevention strategies for people with dementia.Objective: To review gait parameters and characteristics associated with falls in people with dementia.Methods: Electronic databases CINAHL, EMBASE, MedLine, PsycINFO, and PubMed were searched (from inception to April 2017) to identify prospective cohort studies evaluating the association between gait and falls in people with dementia.Results: Increased double support time variability, use of mobility aids, walking outdoors, higher scores on the Unified Parkinson's Disease Rating Scale, and lower average walking bouts were associated with elevated risk of any fall. Increased double support time and step length variability were associated with recurrent falls. The reviewed articles do not support using the Performance Oriented Mobility Assessment and the Timed Up-and-Go tests to predict any fall in this population. There is limited research on the use of dual-task gait assessments for predicting falls in people with dementia.Conclusion: This systematic review shows the specific spatiotemporal gait parameters and features that are associated with falls in people with dementia. Future research is recommended to focus on developing specialized treatment methods for these specific gait impairments in this patient population.

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Fall determinants in older long-term care residents with dementia: a systematic review

Cited by 49 publications

References 39 publications

Quantitative Mobility Assessment for Fall Risk Prediction in Dementia: A Systematic Review

Quantitative Mobility Assessment for Fall Risk Prediction in Dementia: A Systematic Review

A Population‐Based Study Examining Injury in Older Adults with and without Dementia

Gait parameters and characteristics associated with increased risk of falls in people with dementia: a systematic review

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