Journal Mobile Options
Table of Contents
Vol. 10, No. 2, 1999
Issue release date: March–April 1999
Section title: Original Research Article
Dement Geriatr Cogn Disord 1999;10:97–103
(DOI:10.1159/000017108)

The Prevalence, Assessment and Associations of Falls in Dementia with Lewy Bodies and Alzheimer’s Disease

Ballard C.G. · Shaw F. · Lowery K. · McKeith I. · Kenny R.
aMRC Neurochemical Pathology Unit, bRoyal Victoria Infirmary and cUniversity of Newcastle upon Tyne, UK

Do you have an account?

Register and profit from personalized services (MyKarger) Login Information

Please create your User ID & Password





Contact Information









I have read the Karger Terms and Conditions and agree.

Register and profit from personalized services (MyKarger) Login Information

Please create your User ID & Password





Contact Information









I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Buy

  • FullText & PDF
  • Unlimited re-access via MyKarger (new!)
  • Unrestricted printing, no saving restrictions for personal use
  • Reduced rates with a PPV account
read more

Direct: USD 38.00
Account: USD 26.50

Select

Rent/Cloud

  • Rent for 48h to view
  • Buy Cloud Access for unlimited viewing via different devices
  • Synchronizing in the ReadCube Cloud
  • Printing and saving restriction apply

Rental: USD 8.50
Cloud: USD 20.00

Select

Subscribe

  • Automatic perpetual access to all articles of the subscribed year(s)
  • Unlimited re-access via Subscriber Login or MyKarger
  • Unrestricted printing, no saving restrictions for personal use
read more

Subcription rates


Select


Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Published online: 2/26/1999

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 4

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: http://www.karger.com/DEM

Abstract

Falls were assessed for 3 months using a daily fall diary in 65 (30 dementia with Lewy bodies, DLB; 35 Alzheimer’s disease, AD) dementia patients from a case register, diagnosed using operationalised clinical criteria, with established accuracy against post-mortem. Multiple falls (>5) occurred in 37% of DLB patients and 6% of those with AD, often resulting in injury. None of the standard risk assessment tools identified fallers, but they did identify multiple fallers. More detailed evaluation methods examining gait patterns, sway and neurovascular instability were not helpful. Multiple falls were associated with DLB, parkinsonism, previous falls, greater impairment of activities of daily living and older age. Falls are particularly common in DLB sufferers and may aid diagnosis. Treatment studies evaluating fall reduction strategies are a priority.


Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Published online: 2/26/1999

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 4

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: http://www.karger.com/DEM


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Baker BR, Duckworth T, Wilkes E: Mental state and other prognostic factors in femoral fractures of the elderly. J R Coll Gen Pract 1978;28:557–559.
  2. Buchner DM, Larson EB: Falls and fractures in patients with Alzheimer-type dementia. JAMA 1987;257:1492–1495.
  3. Sattin RW: Falls among older persons: A public health perspective. Annu Rev Public Health 1992;13:489–508.
  4. Asada T, Kariya T, Kinoshita T, Asake A: Predictors of fall-related injuries amongst community-dwelling elderly people with dementia. Age Ageing 1996;25:22–28.
  5. Thapa PB, Gideon P, Fought RL, Ray WA: Psychotropic drugs and risk of recurrent falls in ambulatory nursing home residents. Am J Epidemiol 1995;142:202–211.
  6. Jantti PD, Pygkko VI, Hervonen AL: Falls amongst elderly nursing home residents. Public Health 1993;107:89–96.
  7. Kantern DN, Mulrow CD, Gerety MB, Lichtenstein MJ, Aguilar C, Cornell JE: Falls: An examination of three reporting methods in nursing homes. J Am Geriatr Soc 1993;41:662–666.
  8. Tinnetti ME: Performance-orientated assessment of mobility problems in elderly patients. J Am Geriatr Soc 1986;34:119–126.
  9. Kock M, Gottschalk M, Baker DI, Palumbo S, Tinetti ME: An impairment and disability assessment and treatment protocol for community-living elderly persons. Phys Ther 1994;74:286–294.
  10. Smith R: Validation and reliability of the elderly mobility scale. Physiotherapy 1994;80:744–747.
  11. Oleske DM, Wilson RS, Bernard BA: Epidemiology of injury in people with Alzheimer’s disease. J Am Geriatr Soc 1995;43:741–746.
  12. Van Dijk PT, Mendenberg OG, Van der Sande JJ, Habbems TD: Falls in dementia patients. Gerontologist 1993;33:200–204.
  13. Burns A, Luthert P, Levy R, Jacoby R, Lantos P: Accuracy of clinical diagnosis of Alzheimer’s disease. BMJ 1990;301:1026.
  14. Lennox G, Lowa J, Morrell K, Landon M, Mayer RJ: Antiubiquitin immunocytochemistry is more sensitive than conventional techniques in the detection of diffuse Lewy body disease. J Neurol Neurosurg Psychiatry 1989;52:67–71.
  15. Kosaka K: Diffuse Lewy body disease in Japan. J Neurol 1990;237:197–204.
  16. Hansen L, Salmon D, Galasko D: The Lewy body variant of Alzheimer’s disease: A clinical and pathological entity. Neurology 1990;40: 1–8.
  17. Perry RH, Irving D, Blessed G, Fairbairn A, Perry EK: A clinically and pathologically distinct form of Lewy body dementia in the elderly. J Neurol Sci 1990;95:119–139.
  18. Ballard CG, Mohan RNC, Patel A, Bannister C: Idiopathic clouding of consciousness – Do the patients have cortical Lewy body disease? Int J Geriatr Psychiatry 1993;8:571–576.
  19. Shergill S, Mullen E, D’Ath P, Katona C: What is the clinical prevalence of Lewy body dementia? Int J Geriatr Psychiatry 1994;9:907–912.
  20. Perry EK: Operational criteria for senile dementia of Lewy body type. Psychol Med 1992;22:911–922.
  21. Dewey ME, Copeland JRM, Lobo A, Saz P, Dia JL: Computerised diagnosis made from standardised history schedule: A preliminary communcation about the organic section of the HAS AGECAT system. Int J Geriatr Psychiatry 1992;7:443–447.
  22. Roth M, Tym E, Mountjoy C, Huppert FA, Hendric H, Verma S, Goddard R: CAMDEX: A standardised instrument for the diagnosis of mental disorders in the elderly with special reference to the early detection of dementia. Br J Psychiatry 1986;149:698–709.
  23. Folstein MF, Folstein SE, McHugh PR: Mini mental state examination. J Psychiatr Res 1975;12:189–198.
  24. Mahoney FI, Barthel DW: Functional: The Barthel Index. Md Med J 1965;14:61–65.
  25. Ballard C, McKeith I, Burn D, Harrison R, O’Brien J, Lowery K, Campbell M, Perry R, Ince P: The UPDRS scale as a means of identifying extrapyramidal signs in patients suffering from dementia with Lewy bodies. Acta Neurol Scand 1997;96:366–371.
  26. McKeith IG, Galasko D, Kosaka K, Perry EK, Dickson DW, Hansen LA, Salmon DP, Lowe J, Mirra SS, Byrne EJ, Lennox G, Quinn NP, Edwardson JA, Ince PG, Bergeron C, Burns A, Miller BL, Lovestone S, Collerton D, Jansen ENH, Ballard C, de Vos RAI, Wilcock GK, Jellinger KA, Perry RH: Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB). Neurology 1996;47:1113–1124.
  27. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM: Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Forces on Alzheimer’s Disease. Neurology 1984;34:939–944.
  28. McKeith IG, Ballard CG, Perry RH, Ince P, Jaros E, Neill D, O’Brien J: Predictive accuracy of clinical diagnostic care for dementia with Lewy bodies – prospective neuropathology validation study (abstract). Neurology 1998;50(suppl 4):181.
  29. Tideiskaar R: Preventing falls: Home hazards checklists to help older patients protect themselves. Geriatrics 1986;41:26–28.
  30. Walker DJ, Chandler C, Essex T, Heslop P, Stead H, Kiff P: Patient activity as an objective measure of NSAID therapy: An Arthrotec and Numact study. Br J Rheumatol 1995;34(suppl II):15.
  31. Fitzgerald JE, Murray A, Elliott C, Birchall HP: Comparison of body sway analysis techniques: Assessment with subjects standing on a stable surface. Acta Ocolaryngol (Stockh) 1994;114:115–119.
  32. Richardson DA, Bexton RS, Shaw FE, Bond J, Kenny RA: Prevalence of cardioinhibitory carotid sinus hypersensitivity (CICSH) in accident and emergency attendances with falls or syncope. PACE 1997;20:820–823.
  33. SPSS/PC+: Statistical Package for the Social Sciences, Version 3.1, ed 2. New York, McGraw-Hill, 1988.