Mismatch of Subjective and Objective Risk of Falling in Patients with Dementia

Klaus Hauer*, Michael Schwenk, Stefan Englert, Rixt Zijlstra, Sabine Tuerner, Ilona Dutzi*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Web of Science)

Abstract

Background: Match or mismatch of objective physiological and subjectively perceived fall risk may have serious consequences in patients with dementia (PwD) while research is lacking.

Objective: To analyze mismatch of objective and subjective fall risk and associated factors in PwD.

Method: Cohort study in a geriatric rehabilitation center. Objective and subjective risk of falling were operationalized by Tinetti's Performance Oriented Mobility Assessment and the Falls Efficacy Scale-International. Four sub-groups according to objective and subjective fall risk were classified. Subgroups were compared for differences in clinical, cognitive, psychological, and behavioral variables.

Results: In geriatric rehab patients with mild to moderate dementia (n=173), two-thirds showed a mismatch of subjective versus objective risk of falling, independently associated with previous falls. Underestimation of objective fall risk (37.6%) was determined by lower activity avoidance (OR 0.39), less concerns about falling due to previous falls (OR 0.25), and higher quality of life (OR 1.10), while overestimation (28.9%) was determined by higher rate of support seeking strategies (OR 50.3), activity avoidance (OR 15.2), better executive (OR 21.0) and memory functions (OR 21.5), and lower quality of life (OR.75) in multivariate logistic regression.

Conclusion: The majority of patients showed a mismatch between objective and subjective falls risk. Underestimation as well as overestimation of fall risk was associated with specific profiles based on cognitive- and psychological status, falls and fall-related behavioral consequences which should be included in the comprehensive assessment of fall risk, and planning of individualized fall prevention programs for this population.

Original languageEnglish
Pages (from-to)557-572
Number of pages16
JournalJournal of Alzheimer's Disease
Volume78
Issue number2
DOIs
Publication statusPublished - 2020

Keywords

  • Cognitive impairment
  • dementia
  • elderly
  • fall risk
  • falls
  • fear of falling
  • MILD COGNITIVE IMPAIRMENT
  • ALZHEIMERS-DISEASE
  • ELDERLY PERSONS
  • OLDER-ADULTS
  • PSYCHOLOGICAL CONCERNS
  • ACTIVITY RESTRICTION
  • TOTAL SCORE
  • FEAR
  • PREVALENCE
  • CARE

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