Hong Kong Physiotherapy Journal
Volume 23, Issue 1 , Pages 20-26, 2005

A Pilot Falls-prevention Programme for Older People with Dementia from A Predominantly Italian Background

  • Shylie F. Mackintosh, MSc

      Affiliations

    • Corresponding Author InformationReprint requests and correspondence to: Shylie F. Mackintosh, School of Health Sciences, University of South Australia, City East Campus, North Terrace, Adelaide, South Australia 5000, Australia
  • ,
  • Lorraine A. Sheppard, PhD

School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia

Received 23 August 2004; accepted 5 July 2005.

Article Outline

Abstract 

This pilot study aimed to assess the feasibility and effectiveness of a falls-prevention programme for older people with dementia from predominantly an Italian background. The study had a single group pretest- posttest design and enrolled 64 community-dwelling older people with dementia; 6-month follow-up data were available for 32 participants. The falls-prevention programme was embedded in a healthy lifestyle dementia respite programme, which combined day respite with preventative health programmes. A comprehensive falls risk assessment was conducted for each client to develop an individualised falls and injury management plan that included a tailored exercise programme to improve strength and balance. Outcome measurements were fall status, cognitive function (Mini Mental State Examination, MMSE), balance (Berg Balance Scale, BBS) and aerobic capacity (6-minute walk test). There were no significant differences between baseline and 6-month measures for the number of fallers, BBS, MMSE or 6-minute walk test (n = 32; p > 0.05), indicating that participants neither improved nor declined significantly. A feasible method of delivering falls prevention services to older people with dementia has been developed. There is a need for further investigation to establish the effectiveness of this method.

Key words:  dementia , falls prevention , aged care

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References 

  1. Bueno-Cavanillas A , Padilla-Ruiz F , Jimenez-Moleon JJ , et al.   Risk factors in falls among the elderly according to extrinsic and intrinsic precipitating causes . Eur J Epidemiol . 2000;16:849–859
  2. Gostynski M , Ajdacic-Gross V , Heusser-Gretler R , et al.   Dementia, depressive symptoms and activities of daily living as risk factors for falls among elderly . Soz Praventivmed . 2001;46:123–130
  3. van Doorn C , Gruber-Baldini AL , Zimmerman S , et al.   Dementia as a risk factor for falls and fall injuries among nursing home residents . J Am Geriatr Soc . 2003;51:1213–1218
  4. Asada T , Kariya T , Kinoshita T , et al.   Predictors of fall-related injuries among community-dwelling elderly people with dementia . Age Ageing . 1996;25:22–28
  5. Rowe MA , Fehrenbach N . Injuries sustained by community-dwelling individuals with dementia . Clin Nurs Res . 2004;13:98–116
  6. Ballard CG , Shaw F , Lowery K , et al.   The prevalence, assessment and associations of falls in dementia with Lewy bodies and Alzheimer's disease . Dement Geriatr Cogn Disord . 1999;10:97–103
  7. Kanemura N , Kobayashi R , Inafuku K , et al.   Analysis of risk factors for falls in the elderly with dementia . Phys Ther . 2000;12:27–31
  8. Shaw FE , Bond J , Richardson DA , et al.   Multifactorial intervention after a fall in older people with cognitive impairment and dementia presenting to the accident and emergency department: randomised controlled trial . BMJ . 2003;326:73
  9. Brill PA , Drimmer AM , Morgan LA , et al.   The feasibility of conducting strength and flexibility programs for elderly nursing home residents with dementia . Gerontologist . 1995;35:263–266
  10. Buckler JE , Dutton TL , MacLeod HL , et al.   Use of hip protectors on a dementia unit . Physiother Can . 1997;49:297–299 310.
  11. Pomeroy VM , Warren CM , Honeycombe C , et al.   Mobility and dementia: is physiotherapy treatment during respite care effective? . Int J Geriatr Psychiatry . 1999;14:389–397
  12. Toulotte C , Fabre C , Dangremont B , et al.   Effects of physical training on the physical capacity of frail, demented patients with a history of falling: a randomised controlled trial . Age Ageing . 2003;32:67–73
  13. Jensen J , Nyberg L , Gustafson Y , et al.   Fall and injury prevention in residential care-effects in residents with higher and lower levels of cognition . J Am Geriatr Soc . 2003;51:627–635
  14. Laws A , Drummond M . The complexities of interviewing Italo-Australian men about sensitive health issues . Contemp Nurse . 2002;12:144–154
  15. American Geriatrics Society, British Geriatrics Society, American Academy of Orthopaedic Surgeons Panel on Falls Prevention  . Guidelines for prevention of falls in older people . J Am Geriatr Soc . 2001;49:664–672
  16. Berg KO , Wood-Dauphinee SL , Williams JI , et al.   Measuring balance in the elderly: preliminary development of an instrument . Physiother Can . 1986;41:304–311
  17. Podsiadlo D , Richardson S . The timed “up & go”: A test of basic functional mobility for frail elderly persons . J Am Geriatr Soc . 1991;39:142–148
  18. Shumway-Cook A . S. B, M. W. Predicting the probability for falls in community-dwelling older adults using the timed up & go test . Phys Ther . 2000;80:896–903
  19. Steffen TM , Hacker TA , Mollinger L . Age and gender related test performance in community-dwelling elderly people: 6 minute walk test, Berg Balance scale, Timed Up & Go Test, and gait speeds . Phys Ther . 2002;82:128–137
  20. Folstein MF , Folstein SE , McHugh PR . “Mini Mental State”. A practical method for grading the cognitive state of patients for the clinician . J Psychiatr Res . 1975;12:189–198
  21. Berg KO , Wood-Dauphinee SL , Williams JI , et al.   Measuring balance in the elderly: validation of an instrument . Can J Public Health . 1992;83(Suppl 2):S7–11
  22. Harada ND , Chiu V , Stewart AL . Mobility-related function in older adults: assessment with a 6 minute walk test . Arch Phys Med Rehabil . 1999;80:837–841
  23. Maki BE , McLlroy WE . Control of compensatory stepping reactions: age-related impairment and the potential for remedial intervention . Physiother Theory Pract . 1999;15:69–90
  24. Lord SR , Sambrook PN , Gilbert C , et al.   Postural stability, falls and fractures in the elderly: results from the Dubbo Osteoporosis Epidemiology Study . Med J Aust . 1994;160:684–691
  25. Whipple RH , Wolfson LI , Amerman PM . The relationship of knee and ankle weakness to falls in nursing home residents: an isokinetic study . J Am Geriatr Soc . 1987;35:13–20
  26. Kendall FP , Kendall McCreary E , Provance PG . Muscles, Testing and Function: with Posture and Pain . 4th edition. Baltimore: Williams and Wilkins; 1993;
  27. Beasley WC . Quantitative muscle testing: principles and applications to research and clinical services . Arch Phys Med Rehabil . 1961;42:398–425
  28. Friedman R , Tappen RM . The effect of planned walking communication in Alzheimer's Disease . J Am Geriatr Soc . 1991;39:650–654
  29. Holmberg SK . Evaluation of a clinical intervention for wanderers on a geriatric nursing unit . Arch Psychiatr Nurs . 1997;11:21–28
  30. Laurin D , Verreault R , Lindsay J , et al.   Physical activity and risk of cognitive impairment and dementia in elderly persons . Arch Neurol . 2001;58:498–504

PII: S1013-7025(09)70055-7

doi:10.1016/S1013-7025(09)70055-7

Hong Kong Physiotherapy Journal
Volume 23, Issue 1 , Pages 20-26, 2005