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The impact of neurological disorders on the risk for falls in the community dwelling elderly: a case-controlled study
  1. Barbara Homann1,
  2. Annemarie Plaschg1,
  3. Marion Grundner1,
  4. Alice Haubenhofer1,
  5. Theresa Griedl1,
  6. Gerd Ivanic2,
  7. Edith Hofer1,
  8. Franz Fazekas1,
  9. Carl Nikolaus Homann1,3
  1. 1Department of Neurology, Medical University Graz, Graz, Austria
  2. 2Department of Orthopaedic Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
  3. 3Department of Public Health, St. Elisabeth University of Health and Social Sciences, Bratislava, Slowakia
  1. Correspondence to Professor Carl Nikolaus Homann; nik.homann{at}medunigraz.at, nick_homann{at}yahoo.de

Abstract

Objectives Owing to a lack of data, our aim was to evaluate and compare the impact of various common neurological diseases on the risk for falls in independent community dwelling senior citizens.

Design Prospective case-controlled study.

Setting General hospital.

Participants Of 298 consecutive patients and 214 controls enrolled, 228 patients (aged 74.5±7.8; 61% women) and 193 controls (aged 71.4±6.8; 63% women) were included. The exclusion criteria were as follows: for patients, severe disability, disabling general condition or severe cognitive impairment; for controls, any history of neurological disorders or disabling medical conditions; and for both, age below 60 years. A matching process led to 171 age-matched and gender-matched pairs of neurological patients and healthy controls.

Main outcome measures A 1-year incidence of falls based on patients' 12-month recall; motor and non-motor function tests to detect additional risk factors.

Results 46% of patients and 16% of controls fell at least once a year. Patients with stroke (89%), Parkinson’s disease (77%), dementia (60%) or epilepsy (57%) had a particularly high proportion of fallers, but even subgroups of patients with the least fall-associated neurological diseases like tinnitus (30%) and headache (28%) had a higher proportion of fallers than the control group. Neuropathies, peripheral nerve lesions and Parkinson's disease were predisposing to recurrent falls. A higher number of neurological comorbidities (p<0.001), lower Barthel Index values (p<0.001), lower Activities-Specific Balance Confidence scores (p<0.001) and higher Center of Epidemiological Studies Depression scores (p<0.001) as well as higher age (p<0.001) and female gender (p=0.003) proved to further increase the risk of falls.

Conclusions Medical practitioners, allied health professionals and carers should be aware that all elderly neurological patients seen in outpatient settings are potentially at high risk for falls; they should query them routinely about previous falls and fall risks and advise them on preventive strategies.

  • Falls
  • fall risk
  • elderly
  • community dwelling
  • neurological disorders

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

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