Specific motor and cognitive performances predict falls during ward-based geriatric rehabilitation in patients with dementia
The aim of this study was to identify in-hospital fall risk factors specific for multimorbid hospitalized geriatric patients with dementia (PwD) during hospitalization. Geriatric inpatients during ward-based rehabilitation (n = 102; 79.4% females; 82.82 (6.19) years of age; 20.26 (5.53) days of stay...
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| Hauptverfasser: | , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
20 September 2020
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| In: |
Sensors
Year: 2020, Jahrgang: 20, Heft: 18 |
| ISSN: | 1424-8220 |
| DOI: | 10.3390/s20185385 |
| Online-Zugang: | Verlag, Volltext: https://doi.org/10.3390/s20185385 Verlag: https://www.mdpi.com/1424-8220/20/18/5385 
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| Verfasserangaben: | Klaus Hauer, Ilona Dutzi, Katharina Gordt and Michael Schwenk |
| Zusammenfassung: | The aim of this study was to identify in-hospital fall risk factors specific for multimorbid hospitalized geriatric patients with dementia (PwD) during hospitalization. Geriatric inpatients during ward-based rehabilitation (n = 102; 79.4% females; 82.82 (6.19) years of age; 20.26 (5.53) days of stay) were included in a comprehensive fall risk assessment combining established clinical measures, comprehensive cognitive testing including detailed cognitive sub-performances, and various instrumented motor capacity measures as well as prospective fall registration. A combination of unpaired t-tests, Mann–Whitney-U tests, and Chi-square tests between patients with (“in-hospital fallers”) and without an in-hospital fall (“in-hospital non-fallers”), univariate and multivariate regression analysis were used to explore the best set of independent correlates and to evaluate their predictive power. In-hospital fallers (n = 19; 18.63%) showed significantly lower verbal fluency and higher postural sway (p < 0.01 to 0.05). While established clinical measures failed in discriminative as well as predictive validity, specific cognitive sub-performances (verbal fluency, constructional praxis, p = 0.01 to 0.05) as well as specific instrumented balance parameters (sway area, sway path, and medio-lateral displacement, p < 0.01 to 0.03) significantly discriminated between fallers and non-fallers. Medio-lateral displacement and visuospatial ability were identified in multivariate regression as predictors of in-hospital falls and an index combining both variables yielded an accuracy of 85.1% for fall prediction. Results suggest that specific cognitive sub-performances and instrumented balance parameters show good discriminative validity and were specifically sensitive to predict falls during hospitalization in a multimorbid patient group with dementia and an overall high risk of falling. A sensitive clinical fall risk assessment strategy developed for this specific target group should include an index of selected balance parameters and specific variables of cognitive sub-performances. |
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| Beschreibung: | Online Resource |
| ISSN: | 1424-8220 |
| DOI: | 10.3390/s20185385 |