Having Dementia Increases Risk of Falls

Dorian Martin Health Guide
  • Aging brings with it new challenges. Your body doesn’t work quite the same way. And what if your mind also begins to fail? Will you be aware of the challenges you will be facing, especially as it relates to falling?

    A new study out of Japan suggests that the severity of cognitive impairment may affect whether a person recognizes a fear of falling. This study involved 4,474 participants who took part in the Obu Study of Health Promotion for the Elderly. At the start of the study, researchers screened the participants using cognitive tests. Using these results, the participants were placed into one of three groups – cognitively healthy, mild cognitive impairment and global cognitive impairment. The researchers also looked at each participant’s fall history, physical function and depression.

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    Their analysis found that participants who were in the mild cognitive impairment group had the highest fear of falling. However (and perhaps, not surprisingly), the global cognitive impairment group had the lowest level of fear regarding falling, even though they also had the lowest physical function.

    So what does this mean for caregivers? I’d suggest that we need to prepare ourselves to step in more and more to ensure that our loved one does not fall since he or she may not realize the risk, especially as the condition progresses. Furthermore, we need to realize that there could be a variety of reasons that a person with cognitive impairment falls. Obviously, environmental hazards can play a part. However, physical issues – such as failing coordination and muscular weakness – can be the root cause of a fall. In addition, the encroaching cognitive changes may also sabotage the person’s coordination and perception, thus setting up for a fall.

    So let’s address the progression of dementia as it relates to falls. Even though people in the early stages of dementia have a similar risk of falls as people who are not cognitively impaired, that risk level cam increase sharply if they are placed on certain medications.  For instance, antipsychotic medications can cause increased physical stiffness, thus making a person with cognitive impairment more at risk of falling.

    At the middle stage of dementia, people lose their coordination as the area of the brain responsible for complex motor skills comes under attack by the disease.  Couple that with increased agitation, and it’s no wonder that these people have a higher risk of falling. Then you add in the declines in the person’s comprehension about their environment.  For instance, they may not recognize a step and, thus, not align their body properly to handle the change in elevation.
    People who are in the later stages of dementia are even more at risk of falls since they can forget how to walk. They often lose the coordination between their legs and their trunk and are not sure about foot placement.

    Therefore, it’s important that you take all precautions to help the person who has dementia remain upright. These precautions can include:

    • Exercise, which can help them maintain their strength, balance and coordination.
    • Proper vision through regular eye examinations and updated prescription eyewear.
    • Take care of fall hazards, such as clutter and poor lighting.
    • Install handrails on all staircases and grab bars in the bathroom.
    • Remove or secure throw rugs.
    • Keep necessary items within easy reach so the loved one doesn’t have to reach or climb onto a step ladder.
    • Place non-slip mats in the shower or tub.
    • Improve the lighting throughout the house and especially around stairs.
    • Encourage the person to wear sturdy shoes with gripping treads while both inside and outside the home. Avoid letting them wear slip-on shoes such as thongs or slippers. Also don’t let them go barefoot or walk around only wearing socks, if at all possible.

    Primary Sources for This Sharepost:

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    Centers for Disease Control and Prevention. (2013). Preventing falls among older adults.

    Reidinger, L. (ND). Fall into falls.

    Uemura, K., et al. (2014). Effects of mild and global cognitive impairment on the prevalence of fear of falling in community-dwelling older adults. Maturitas.

Published On: April 17, 2014