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Identifying Fallers among Home Care Clients with Dementia and Parkinson’s Disease

Published online by Cambridge University Press:  18 July 2016

Symron Bansal ,
John P. Hirdes ,
Colleen J. Maxwell ,
Alexandra Papaioannou  and
Lora M. Giangregorio
Symron Bansal
Affiliation:
Department of Kinesiology, University of Waterloo
John P. Hirdes
Affiliation:
School of Public Health and Health Systems, University of Waterloo
Colleen J. Maxwell
Affiliation:
School of Pharmacy, University of Waterloo
Alexandra Papaioannou
Affiliation:
Department of Medicine, McMaster University
Lora M. Giangregorio*
Affiliation:
Department of Kinesiology, University of Waterloo
*
†La correspondance et les demandes de tire-à-part doivent être adressées à: / Correspondence and requests for offprints should be sent to: Dr. Lora Giangregorio University of Waterloo 200 University Ave W Waterloo, ON N2L 3G1 (lora.giangregorio@uwaterloo.ca)
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Abstract

Few studies have focused on falls among home care (HC) clients with neurological conditions. This study identified factors that increase risk of falling among HC clients with no recent history of falls, and explored whether risk profiles varied among those with dementia or parkinsonism compared to those without selected neurological conditions. A retrospective cohort design was used and analysis of data from community-based HC clients across Ontario was conducted on a sample of ambulatory clients with dementia, parkinsonism, or none of the selected neurological conditions. Data were obtained from the Resident Assessment Instrument for HC (RAI-HC) assessment. The outcome used in multivariable analyses was whether clients fell during follow-up. Unsteady gait was a strong predictor of falls across all three groups. Co-morbid parkinsonism most strongly predicted falls in the dementia group. Clients with borderline intact to mild cognitive impairment had higher odds of falling within the parkinsonism and comparison groups.

Résumé

Il y a eu peu d’études qui se concentrent sur les chutes chez les clients qui reçoivent des soins à domicile (SD) avec des conditions neurologiques. Cette étude a identifié les facteurs qui accroissent le risque de chutes chez les clients SD sans histoire récente de telles chutes, et a exploré si les profils de risque variaient parmi les personnes atteintes de démence ou le parkinsonisme, par rapport à celles sans conditions neurologiques sélectionnés. Une étude de cohorte rétrospective a été utilisée, et l’analyse des données provenant de clients SD communautaires de l’Ontario a été menée sur un échantillon de clients ambulatoires atteints de démence, de parkinsonisme, ou d’aucune des conditions neurologiques sélectionnées. Les données ont été obtenues à partir de l’instrument d’évaluation des résidents en soins à domicile (IERSD-SD). Dans l’analyse multivariée, le résultat utilisé était de savoir si les clients ont tombé au cours du suivi. Une démarche instable était un fort prédicteur des chutes dans les trois groupes. Le parkinsonisme co-morbide a prédit plus fortement les chutes dans le groupe de démence. Les clients qui ont montré la limite intacte à la déficience cognitive légère étaient plus susceptibles de se sont trouvés dans les groupes de parkinsonisme et de comparaison. Les chances de tomber étaient plus élevées pour les clients avec la limite intacte à la déficience cognitive légère qui également faisaient partie des groupes de la maladie de Parkinson et de comparaison.

Keywords

agingdementiafallshome careinterRAIParkinson’s diseasevieillissementchutessoins à domicileinstrument d’évaluation des residents en soins à domicile (IERSD)maladie de Parkinson (parkinsonisme)
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 35 , Issue 3 , September 2016 , pp. 319 - 331
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Copyright
Copyright © Canadian Association on Gerontology 2016 

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