Lara Harvey1, Rebecca Mitchell2, Henry Brodaty3, Brian Draper4, Jacqueline Close5. 1. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Barker Street, Randwick, NSW 2031, Australia; School of Public Health and Community Medicine, UNSW, NSW 2052, Australia. Electronic address: l.harvey@neura.edu.au. 2. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Barker Street, Randwick, NSW 2031, Australia; Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, NSW 2109 Australia, Australia. Electronic address: r.mitchell@mq.edu.au. 3. Dementia Collaborative Research Centre-Assessment and Better Care, UNSW, School of Psychiatry, Level 3, AGSM Building, UNSW, NSW 2052 Australia; Centre for Healthy Brain Ageing, School of Psychiatry, UNSW, Euroa Centre, School of Psychiatry UNSW Medicine, NSW 2031 Australia. Electronic address: h.brodaty@unsw.edu.au. 4. Dementia Collaborative Research Centre-Assessment and Better Care, UNSW, School of Psychiatry, Level 3, AGSM Building, UNSW, NSW 2052 Australia; Centre for Healthy Brain Ageing, School of Psychiatry, UNSW, Euroa Centre, School of Psychiatry UNSW Medicine, NSW 2031 Australia. Electronic address: b.draper@unsw.edu.au. 5. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Barker Street, Randwick, NSW 2031, Australia; Prince of Wales Clinical School, UNSW Medicine, NSW 2052 Australia. Electronic address: j.close@neura.edu.au.
Abstract
OBJECTIVES: To explore the impact of dementia on the trends in fall-related fracture and non-fracture injuries for older people. METHODS: Individuals aged ≥65years who were admitted to a NSW hospital for at least an over-night stay for a fall-related injury from 2003 to 2012 were identified. Age-standardised hospitalisation rates, length of stay, access to in-hospital rehabilitation, 30-day and 1-year mortality were examined. Annual percentage change (PAC) over time was calculated using negative binomial regression. RESULTS: Of the 228,628 fall-related injury hospitalisations, 20.6% were for people with dementia. People with dementia were more likely to be admitted with a hip fracture, and less likely to be admitted with a fracture of the forearm/wrist, and received less in-hospital rehabilitation than people without dementia. Fall-related hip-fracture rates for people with dementia decreased by 4.2% (95%CI -5.6 to -2.7, p<0.001) per annum; there was no change over time for people without dementia (PAC-0.2%; 95%CI -0.8 to 0.5, p=0.643). Rates for other fractures decreased by 1.2% (95%CI -1.9 to -0.5, p<0.001) per annum in people with dementia, while rates increased by 2.2% (95%CI 1.9-2.5, p<0.001) for people without dementia. By contrast, non-fracture injuries including traumatic brain injury increased significantly for both people with and without dementia. CONCLUSION: Rates of fall-related fracture and non-fracture hospitalisations for people with dementia remain higher than for those without dementia. However, fall-related fracture hospitalisation rates have decreased for people with dementia, while there has not been a corresponding decrease in people without dementia.
OBJECTIVES: To explore the impact of dementia on the trends in fall-related fracture and non-fracture injuries for older people. METHODS: Individuals aged ≥65years who were admitted to a NSW hospital for at least an over-night stay for a fall-related injury from 2003 to 2012 were identified. Age-standardised hospitalisation rates, length of stay, access to in-hospital rehabilitation, 30-day and 1-year mortality were examined. Annual percentage change (PAC) over time was calculated using negative binomial regression. RESULTS: Of the 228,628 fall-related injury hospitalisations, 20.6% were for people with dementia. People with dementia were more likely to be admitted with a hip fracture, and less likely to be admitted with a fracture of the forearm/wrist, and received less in-hospital rehabilitation than people without dementia. Fall-related hip-fracture rates for people with dementia decreased by 4.2% (95%CI -5.6 to -2.7, p<0.001) per annum; there was no change over time for people without dementia (PAC-0.2%; 95%CI -0.8 to 0.5, p=0.643). Rates for other fractures decreased by 1.2% (95%CI -1.9 to -0.5, p<0.001) per annum in people with dementia, while rates increased by 2.2% (95%CI 1.9-2.5, p<0.001) for people without dementia. By contrast, non-fracture injuries including traumatic brain injury increased significantly for both people with and without dementia. CONCLUSION: Rates of fall-related fracture and non-fracture hospitalisations for people with dementia remain higher than for those without dementia. However, fall-related fracture hospitalisation rates have decreased for people with dementia, while there has not been a corresponding decrease in people without dementia.
Authors: R Mitchell; B Draper; J Close; L Harvey; H Brodaty; V Do; T R Driscoll; J Braithwaite Journal: Osteoporos Int Date: 2019-07-24 Impact factor: 4.507
Authors: R Mitchell; B Draper; H Brodaty; J Close; H P Ting; R Lystad; I Harris; L Harvey; C Sherrington; I D Cameron; J Braithwaite Journal: Osteoporos Int Date: 2020-01-02 Impact factor: 4.507