What Factors Predict Falls in Older Adults Living in Nursing Homes: A Pilot Study

Abstract

Background: In community-dwelling older adults, slow gait speed is linked to falls; however, little is known about the use of gait speed to predict falls in nursing home residents. The prevalence of risk factors for falls in nursing home residents is multifactorial. Objective: The purpose of this study was to examine the relationship between falls and multiple factors such as age, sex, gait speed, mobility device, fear of falling, cognitive function, medication, and environmental causes in a nursing home setting. Material and Methods: Participants were recruited from a nursing home. Independent variables such as age, sex, gait speed for 40 feet, use of a mobility device, fear of falls, cognitive function, medication, and environmental causes of falls were measured and recorded. The dependent variable was falls. Participants were followed-up for a period of six months for falls. Falls were documented from the computerized medical records at the facility. Results: Five of the 16 participants had falls in the follow-up period. Exact logistic regression, bivariate analysis, showed no significant relationship between falls and the independent variables of age, sex, gait speed, mobility device, fear of falls, cognitive function, and medication. More than 30% of recorded falls had an environmental cause, which was significant at p = 0.0005. Conclusion: Environmental causes had a significant relationship with falls in nursing home participants. Environment hazard monitoring is therefore important to ensure the safety of nursing home residents.

Center of pressure displacement characteristics differentiate fall risk in older people: A systematic review with meta-analysis

“…Estimating the risk of falling could provide guidance for adapting rehabilitation programs and provision of care. The occurrence of falls depends on extrinsic factors in the environment such as insufficient lighting or obstacles, for example, as well as intrinsic factors related to the physical capacities of the individual (Datta et al, 2018;Deandrea et al, 2013). Intrinsic precipitating causes have been associated with up to 80 % of falls recorded in institutionalized older people, with the highest prevalence amongst the oldest people (Bueno-Cavanillas et al, 2000).…”

Application of Machine Learning Methods in Nursing Home Research: Using Fall-Related Data in Nursing Homes

“…The proportion of residents prescribed psychiatric medications and urinary incontinence were top factors in the logistic regression, RF, SVM polynomial, SVM radial, and SVM sigmoid. Psychiatric medication was a very strong predictor of falls, consistent with previous research [6,7,9,10,[31][32][33], but inconsistent with a couple of studies [34,35]. The proportion of residents with urinary incontinence was an important factor in falls, supported in previous research [9][10][11][12], but not supported in other studies [7,32].…”

Practices and behaviors of professionals after falls in institutionalized elderly with and without cognitive decline

“…A study conducted in the USA concluded that 40.2% of elderly had experienced pre-institutionalization falls, 3 but that falls should also be seen as a consequence of institutionalization, given that they occur at a higher rate 4,5 and lead to more harmful consequences compared to elderly in the community. 1,5 Contributing factors to this increase in prevalence include greater dependence, chronic disease, the environment, cognitive decline and the presence of caregivers. 2,5,6 An unfamiliar environment and the presence of other people hinders risk identification and control, increasing the risk of a fall, particularly in the first few days of institutionalization, when one in five newlyadmitted elderly residents experiences a fall.…”

“…1,5 Contributing factors to this increase in prevalence include greater dependence, chronic disease, the environment, cognitive decline and the presence of caregivers. 2,5,6 An unfamiliar environment and the presence of other people hinders risk identification and control, increasing the risk of a fall, particularly in the first few days of institutionalization, when one in five newlyadmitted elderly residents experiences a fall. 3 It should also be noted that in the first few days of admission, the elderly may feel less confident performing daily living activities, which contributes to increased risk.…”

“…6 The change in epidemiological profile among the elderly -and the associated increase in accidents, mortality, and morbidity -clearly points to the importance of new health models that invest in promoting active aging, the prevention of falls, and a positive cost-benefit relationship, while improving risk identification, the provision of information and assistance to the elderly, and the treatment of after-effects and prevention of post-fall syndrome. [4][5][6][7] As affirmed by some researchers, it is the responsibility of professionals to decrease event incidence, providing care and striving to ensure the safety and wellbeing of the elderly. 5,[8][9][10] With this in mind, the objectives of this study were: a) to construct and validate a scale for assessing the practices and behaviors of professionals in nursing homes after elderly falls (SAPBAEF); b) to describe the practices and behaviors of professionals after falls in institutionalized elderly; and c) to determine the association of practices and behaviors after falls in institutionalized elderly with health professionals' length of experience, training and age.…”