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Specific Motor and Cognitive Performances Predict Falls during Ward-Based Geriatric Rehabilitation in Patients with Dementia

Specific Motor and Cognitive Performances Predict Falls during Ward-Based Geriatric Rehabilitation in Patients with Dementia

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HAUER, Klaus, Ilona DUTZI, Katharina GORDT, Michael SCHWENK, 2020. Specific Motor and Cognitive Performances Predict Falls during Ward-Based Geriatric Rehabilitation in Patients with Dementia. In: Sensors. MDPI. 20(18), 5385. eISSN 1424-8220. Available under: doi: 10.3390/s20185385

@article{Hauer2020-09-20Speci-54536, title={Specific Motor and Cognitive Performances Predict Falls during Ward-Based Geriatric Rehabilitation in Patients with Dementia}, year={2020}, doi={10.3390/s20185385}, number={18}, volume={20}, journal={Sensors}, author={Hauer, Klaus and Dutzi, Ilona and Gordt, Katharina and Schwenk, Michael}, note={Article Number: 5385} }

Attribution 4.0 International Schwenk, Michael Schwenk, Michael Dutzi, Ilona Gordt, Katharina Gordt, Katharina 2020-09-20 Specific Motor and Cognitive Performances Predict Falls during Ward-Based Geriatric Rehabilitation in Patients with Dementia Dutzi, Ilona 2021-08-10T13:46:28Z Hauer, Klaus eng The aim of this study was to identify in-hospital fall risk factors specific for multimorbid hospitalized geriatric patients with dementia (PwD) during hospitalization. Geriatric inpatients during ward-based rehabilitation (n = 102; 79.4% females; 82.82 (6.19) years of age; 20.26 (5.53) days of stay) were included in a comprehensive fall risk assessment combining established clinical measures, comprehensive cognitive testing including detailed cognitive sub-performances, and various instrumented motor capacity measures as well as prospective fall registration. A combination of unpaired t-tests, Mann-Whitney-U tests, and Chi-square tests between patients with ("in-hospital fallers") and without an in-hospital fall ("in-hospital non-fallers"), univariate and multivariate regression analysis were used to explore the best set of independent correlates and to evaluate their predictive power. In-hospital fallers (n = 19; 18.63%) showed significantly lower verbal fluency and higher postural sway (p < 0.01 to 0.05). While established clinical measures failed in discriminative as well as predictive validity, specific cognitive sub-performances (verbal fluency, constructional praxis, p = 0.01 to 0.05) as well as specific instrumented balance parameters (sway area, sway path, and medio-lateral displacement, p < 0.01 to 0.03) significantly discriminated between fallers and non-fallers. Medio-lateral displacement and visuospatial ability were identified in multivariate regression as predictors of in-hospital falls and an index combining both variables yielded an accuracy of 85.1% for fall prediction. Results suggest that specific cognitive sub-performances and instrumented balance parameters show good discriminative validity and were specifically sensitive to predict falls during hospitalization in a multimorbid patient group with dementia and an overall high risk of falling. A sensitive clinical fall risk assessment strategy developed for this specific target group should include an index of selected balance parameters and specific variables of cognitive sub-performances. 2021-08-10T13:46:28Z Hauer, Klaus

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