Call for dementia-focused research into falls prevention

Targeted research is required to develop effective practical interventions to prevent falls amongst older people with dementia, a leading expert on falls has said.

Targeted research is required to develop effective practical interventions to prevent falls amongst older people with dementia, a leading expert on falls has said.

Currently one in three people over 65 will have a fall each year, with 10 per cent suffering a serious injury. However, the rate of falls for people with dementia is higher again, with 50 to 80 per cent of people with dementia who live in community-settings suffering a fall each year. The rates of injury from falls are also higher among the dementia population and more often a trigger for admission to hospital or residential aged care.

Professor Keith Hill
Professor Keith Hill

In recent years many interventions, such as exercise programs and home modifications, have been proven significant in helping to reduce risk of falls among the general population.

However, Keith Hill, head of the School of Physiotherapy and Exercise Science at Curtin University, said there was little research to demonstrate these interventions were also effective in people with dementia as they had often been excluded from research studies, despite the fact they are at a higher risk.

“It’s a significant problem that we’re not getting on top of at the moment,” Professor Hill told Australian Ageing Agenda this week, ahead of his presentation at the upcoming annual National Dementia Research and Knowledge Translation Forum.

“This is a very important and growing group that we’ve got to try to get the research answers for,” he said.

People with dementia can often have reduced safety perception and wandering behaviours, which may put them at further risk of falling. However, Professor Hill pointed out that general risk factors for falls, such as impaired vision, also affect those with dementia and can go unrecognised by clinicians.

“There can be a tendency to just say, the person has dementia and that’s why they’re falling, without looking for the underlying risk factors,” he said. “If you have vision problems, if you have polypharmacy, dealing with those risk factors has to happen whether the person has dementia or not, but it’s how that happens and trying to get engagement with the intervention that is essential.”

Need for focused research

Professor Hill said it was important that future research looked at the unique needs of people with dementia and their carers and how interventions that have been proven to work effectively in the general population could be modified to apply for those with dementia.

One area of research where there was an emerging understanding of how falls could be prevented for people with dementia was exercise. Professor Hill and colleagues recently found that when there were modifications to the way exercise programs were implemented, such as greater involvement of carers and more frequent visits from physiotherapists, there were significant reductions in falls.

“They’re fairly simple things, but they’re modifications of what’s been shown to work in people without dementia,” said Professor Hill.

“All of them have been fairly small studies but when they’ve been pooled together the results show that this does seem to be effective.”

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Tags: dcrc, dementia, Dementia Collaborative Research Centres., falls-prevention, keith hill,

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