Amber D Rochette1, Neil B Alexander2,3, Christine T Cigolle2,3, Robert Hogikyan2,3, Kristin Phillips2, Fareeha A Khan4, Julija Stelmokas5,6,7. 1. VA Ann Arbor Healthcare System Mental Health Service 116b, 2215 Fuller Road, Ann Arbor, MI, 48105, USA. 2. VA Ann Arbor Geriatric Research Education and Clinical Center, Ann Arbor, MI, USA. 3. Michigan Medicine, Ann Arbor, MI, USA. 4. Atrium Health, Charlotte, NC, USA. 5. VA Ann Arbor Healthcare System Mental Health Service 116b, 2215 Fuller Road, Ann Arbor, MI, 48105, USA. jstelmok@med.umich.edu. 6. VA Ann Arbor Geriatric Research Education and Clinical Center, Ann Arbor, MI, USA. jstelmok@med.umich.edu. 7. Michigan Medicine, Ann Arbor, MI, USA. jstelmok@med.umich.edu.
Abstract
BACKGROUND: While repeat falls are common in post-acute care (PAC), risk factors have not been fully elucidated. AIMS: The objective of thids study is to evaluate the contribution of cognitive function to repeat falls in older PAC Veterans. METHODS: Data were collected from medical records for 91 single and 30 repeat fallers over 5 consecutive years (2011-2016). RESULTS: After controlling for demographic and medical factors, lower Mini-Mental State Exam (MMSE) score was associated with increased odds of repeat falls. MMSE scores below 20 (with age held constant at the mean) were associated with a greater than 50% chance of a repeat fall (compared to 24.7% base rate). Admission for a neurologic reason further increased risk. DISCUSSION: PAC Veterans who experience a fall have an increased risk of repeat falls with concomitant cognitive dysfunction and/or admission for neurologic reasons. CONCLUSIONS: Results support tailoring multi-component interventions for those with cognitive dysfunction utilizing standardized mental status screening upon admission.
BACKGROUND: While repeat falls are common in post-acute care (PAC), risk factors have not been fully elucidated. AIMS: The objective of thids study is to evaluate the contribution of cognitive function to repeat falls in older PAC Veterans. METHODS: Data were collected from medical records for 91 single and 30 repeat fallers over 5 consecutive years (2011-2016). RESULTS: After controlling for demographic and medical factors, lower Mini-Mental State Exam (MMSE) score was associated with increased odds of repeat falls. MMSE scores below 20 (with age held constant at the mean) were associated with a greater than 50% chance of a repeat fall (compared to 24.7% base rate). Admission for a neurologic reason further increased risk. DISCUSSION: PAC Veterans who experience a fall have an increased risk of repeat falls with concomitant cognitive dysfunction and/or admission for neurologic reasons. CONCLUSIONS: Results support tailoring multi-component interventions for those with cognitive dysfunction utilizing standardized mental status screening upon admission.