Predictors of falls in older adults with and without dementia

Alzheimers Dement. 2023 Jul;19(7):2888-2897. doi: 10.1002/alz.12916. Epub 2023 Jan 12.

Abstract

Introduction: Persons living with, versus without, dementia (PLWD) have heightened fall-risk. Little is known about whether fall-risk factors differ by dementia status.

Methods: Using the 2015 and 2016 National Health and Aging Trends Study, we prospectively identified fall-risk factors over a 12-month period among community-living older adults ≥65 years with and without dementia (n = 5581).

Results: Fall rates were higher among PLWD compared to persons without dementia (45.5% vs. 30.9%). In a multivariable model including sociodemographic, health, function, and environmental characteristics as predictors, vision impairment (OR: 2.22, 95% CI: 1.12-4.40), and living with a spouse versus alone (OR: 2.43, 95% CI: 1.09-5.43) predicted falls among PLWD, but not among persons without dementia. History of previous falls predicted subsequent falls regardless of dementia status (OR: 6.20, 95% CI: 3.81-10.09, and OR: 2.92, 95% CI: 2.50-3.40, respectively).

Discussion: Incorporating appropriate fall-risk factors could inform effective falls screening and prevention strategies for PLWD.

Highlights: 46% of persons with dementia had ≥1 falls versus 31% of those without dementia in 2016. Vision impairment and living with a spouse predicted falls in persons with dementia. Study results support tailored fall prevention strategies for persons with dementia.

Keywords: accidental falls; dementia; fall risk factors; living arrangement; vision impairment.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Accidental Falls* / prevention & control
  • Aged
  • Dementia* / diagnosis
  • Humans
  • Independent Living
  • Risk Factors