Fiona E. Shaw, MRCP, PhD, Consultant Physician and Geriatrician, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne, UK.
Older people with dementia are at increased risk of falls and their adverse consequences. Postural instability (impaired gait and balance), medication, environmental hazards and neurocardiovascular instability, in particular orthostatic hypotension, are commonly identified as risk factors for falls in this patient group. It is possible to modify risk factors for falls in older people with dementia. However, to date it has not been possible to demonstrate conclusively that intervention can prevent falls in patients with dementia.
Key words: accidental falls, dementia, cognitive impairment, postural instability, neurocardiovascular instability (syncope).
Gabriele Meyer, Research Fellow, Andrea Warnke, Research Fellow and
Ingrid Mühlhauser, Professor; Unit of Health Sciences and Education,
University of Hamburg, Hamburg, Germany.
Prevention of falls in the elderly is a high priority in many countries. Single component and multifaceted interventions have been extensively studied. However, only two interventions have been shown to reduce injuries or fractures. Hip protectors effectively reduce hip fractures. Home-based exercise programs administered by qualified professionals may reduce falls and fall-related injuries. Most interventions are intensive and require substantial resources. Before considering implementation of a fall prevention program, its practicability, acceptance and cost-effectiveness should be explored.
Key words: accidental falls, prevention, hip fractures, hip protector, protective devices.
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