A study published today in JAMA Network Open has found that more than 1 in 10 older adults who go to the emergency department (ED) after falling are diagnosed with Alzheimer’s disease and related dementias within a year of their ED visit—a rate higher than observed for other injuries such as a transportation accident.
Alexander J. Ordoobadi, M.D., of Brigham and Women’s Hospital, and colleagues examined Medicaid Fee-for-Service data from 2014 and 2015 for more than 2.4 million patients ages 66 and older who had a traumatic injury that resulted in a visit to an ED. None of the patients had an existing diagnosis of dementia at the time of their hospital visit.
Overall, about half of study patients experienced a fall, while the other half experienced other traumatic events such as cutting/piercing, overexertion, or transportation mishaps. The researchers found that 10.1% of patients with falls were diagnosed with dementia within one year of their fall, compared with 6.1% of patients with other traumatic injuries. After adjusting for variables like patient demographics and medical comorbidities, the researchers calculated that a traumatic fall was associated with a 21% increased risk of a new dementia diagnosis.
Furthermore, falls were associated with a 27% increased risk of a new dementia diagnosis among older adults who lived at home, compared with a 10% increased risk of those who lived in a skilled nursing facility.
The researchers found that 11% of the new dementia diagnoses in the study occurred during the patients’ hospital visit, suggesting that dementia was likely present but undiagnosed at the time of their fall. They noted the possibility that some of the patients who fell also may have had mild cognitive impairment, a precursor to dementia, at the time of their fall.
“The association between falls and incident dementia diagnosis highlights the need for cognitive screening for older adults who experience a fall that results in an ED visit or hospital admission,” Ordoobadi and colleagues wrote. “Implementing cognitive screening after falls will require a multidisciplinary effort involving the breadth of clinicians who care for older adults after a fall, ranging from trauma surgeons to geriatricians and primary care physicians.”
For related information, see the Journal of Neuropsychiatry and Clinical Neurosciences article “Short Physical Performance Battery and Mediation of the Effect of Mild Cognitive Impairment on Falls by Community-Dwelling Older Adults.”
(Image: Getty Images/iStock/Toru Kimura)
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