Elderly/Long-Term Care

Mental status deficits a major factor in elderly falls in the hospital

Falls in hospitals or other settings are a frequent cause of morbidity and mortality in older people with cognitive impairment, dementia, or confusion. A new study found that a faller's mental status deficit (MSD) was related to falls documented by nurses in fall incident reports. In 34 percent of falls (346 out of 1,017) in adult inpatient acute care settings, MSDs were identified as the dominant factor, according to Huey-Ming Tzeng, Ph.D., of the University of Michigan. Fallers with MSDs tended to have more injurious falls than those without such deficits. They also seemed to have fewer toileting-related falls than patients without such deficits.

Falls may be precipitated by intrinsic or extrinsic risk factors. Intrinsic factors are those integral to the patient, such as age-related changes, previous falls, reduced vision, unsteady gait, chronic illness, medication use, and MSD. Extrinsic factors are environmental and other hazards, such as time of day and staffing.

Dr. Tzeng examined reports of 1,017 falls occurring in 6 inpatient acute care units in a community, not-for-profit hospital between 2005 and 2009. She believes that risk assessment of falls and targeted surveillance should be part of fall-prevention policies for cognitively impaired older patients during hospital stays. This study was supported by the Agency for Healthcare Research and Quality (HS18258).

See "Inpatient falls in adult acute care settings: Influence of patients' mental status," by Dr. Tzeng, in the Journal of Advanced Nursing 66(8), pp. 1741-1746, 2010.

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