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Wabe N, Seaman KL, Nguyen A, Siette J, Raban MZ, Hibbert P, Close J, Lord SR, Westbrook JI. Epidemiology of Falls in 25 Australian Residential Aged Care Facilities: A Retrospective Longitudinal Cohort Study Using Routinely Collected Data. Int J Qual Health Care 2022; 34:6589456. [PMID: 35588391 DOI: 10.1093/intqhc/mzac050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/31/2022] [Accepted: 05/19/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Falls are frequent among older adults and have significant health and economic consequences. There have been few studies on the epidemiology of falls in residential aged care facilities (RACFs). This study aimed to determine the incidence of falls in RACFs using longitudinal routinely collected incident data over five years (Jul 2014-Dec 2019). METHODS A retrospective cohort study using fall incident data from 25 RACFs in Sydney, NSW, Australia. Incidents relating to a population of 6,163 aged care residents aged ≥65 years were included. Outcome measures were incidents of all falls; injurious falls, and requiring hospitalisation. Risk-adjusted incidence rate (IR) for each outcome indicator for each of the 25 facilities was calculated. RESULTS A total of 27,878 falls were reported over 3,906,772 resident days (a crude rate of 7.14/1000 resident days; 95% confidence interval (CI) 6.81-7.48). Of these, 10,365 (37.2%) were injurious and 2,733 (9.8%) required hospitalisation. The crude IR for injurious falls was 2.65/1000 resident days (95% CI 2.53-2.78) and 0.70 (95% CI 0.66-0.74) for falls requiring hospitalisation. The incidence of falls was significantly higher in respite compared to permanent residents for all falls (adjusted incident rate ratio (aIRR) 1.33; 95% CI 1.18-1.51) and injurious falls (aIRR 1.30; 95% CI 1.14-1.48) and for men compared to women for all outcomes (all falls aIRR 1.69; 95% CI 1.54-1.86; injurious falls aIRR 1.87; 95% CI 1.71-2.04 and falls requiring hospitalisation aIRR 1.29; 95% CI 1.12-1.48). The risk-adjusted IRs per 1000 resident days between facilities varied substantially (all falls 0.57-12.93 falls; injurious falls 0.25-4.47 and falls requiring hospitalisation 0.10-1.70). CONCLUSION Falls are frequent in RACFs, often resulting in injury and hospitalisation. The study provides robust and comprehensive information that may help inform future initiatives to minimise the incidence of falls in RACFs.
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Affiliation(s)
- Nasir Wabe
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Karla L Seaman
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Amy Nguyen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Joyce Siette
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Magdalena Z Raban
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Peter Hibbert
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.,Allied Health and Human Performance, South Australian Health & Medical Research Institute (SAHMRI), University of South Australia, Adelaide, South Australia, Australia
| | - Jacqueline Close
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Stephen R Lord
- Neuroscience Research Australia, Sydney, New South Wales, Australia.,School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Johanna I Westbrook
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Silva de Lima AL, Smits T, Darweesh SKL, Valenti G, Milosevic M, Pijl M, Baldus H, de Vries NM, Meinders MJ, Bloem BR. Home-based monitoring of falls using wearable sensors in Parkinson's disease. Mov Disord 2019; 35:109-115. [PMID: 31449705 PMCID: PMC7003816 DOI: 10.1002/mds.27830] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 07/02/2019] [Accepted: 07/15/2019] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Falling is among the most serious clinical problems in Parkinson's disease (PD). We used body-worn sensors (falls detector worn as a necklace) to quantify the hazard ratio of falls in PD patients in real life. METHODS We matched all 2063 elderly individuals with self-reported PD to 2063 elderly individuals without PD based on age, gender, comorbidity, and living conditions. We analyzed fall events collected at home via a wearable sensor. Fall events were collected either automatically using the wearable falls detector or were registered by a button push on the same device. We extracted fall events from a 2.5-year window, with an average follow-up of 1.1 years. All falls included were confirmed immediately by a subsequent telephone call. The outcomes evaluated were (1) incidence rate of any fall, (2) incidence rate of a new fall after enrollment (ie, hazard ratio), and (3) 1-year cumulative incidence of falling. RESULTS The incidence rate of any fall was higher among self-reported PD patients than controls (2.1 vs. 0.7 falls/person, respectively; P < .0001). The incidence rate of a new fall after enrollment (ie, hazard ratio) was 1.8 times higher for self-reported PD patients than controls (95% confidence interval, 1.6-2.0). CONCLUSION Having PD nearly doubles the incidence of falling in real life. These findings highlight PD as a prime "falling disease." The results also point to the feasibility of using body-worn sensors to monitor falls in daily life. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Ana Lígia Silva de Lima
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Tine Smits
- Philips Research, Department Personal Health, Eindhoven, the Netherlands
| | - Sirwan K L Darweesh
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands.,Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Giulio Valenti
- Philips Research, Department Personal Health, Eindhoven, the Netherlands
| | - Mladen Milosevic
- Philips Research North America, Acute Care Solutions Department, Cambridge, Massachusetts, USA
| | - Marten Pijl
- Philips Research, Department Personal Health, Eindhoven, the Netherlands
| | - Heribert Baldus
- Philips Research, Department Personal Health, Eindhoven, the Netherlands
| | - Nienke M de Vries
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
| | - Marjan J Meinders
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands.,Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Nijmegen, the Netherlands
| | - Bastiaan R Bloem
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
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