Factors Associated With Falls Among Residents Living in Long-Term Care Homes in Ontario.
Lori Rietze, Roberta Heale, Robyn Gorham and 1 others
PMID 40556513WHAT IT FOUND
Ontario long-term care residents who wandered, had pain or delirium, recently deteriorated in ADLs or care needs, were incontinent, or took antidepressants, antipsychotics, antianxiety medicines, hypnotics or analgesics were more likely to have fallen in the previous 30 days.
Key findings
01Twenty-one percent of residents had a recorded fall within the past 3 months.
02Falls in the previous 30 days were positively associated with wandering, pain, delirium, urinary and bowel incontinence, recent deterioration in ADLs or care needs, impaired standing balance, and use of antidepressants, antipsychotics, antianxiety medicines, hypnotics or analgesics in the 7 days before assessment.
03Some factors were negatively associated with falls, including dementia, arthritis, impaired sitting balance, assistance with eating, and urban location.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
The study is retrospective and cross-sectional, so it cannot show that a factor caused a fall or that changing the factor would prevent one. The outcome was a fall in the previous 30 days, but the paper also reports fall prevalence over the past 3 months, so the time frame is not fully consistent. Each assessment was analysed separately, so residents with more assessments contributed more than once. Data came from RAI-MDS forms completed by healthcare staff, with possible errors, reporting bias and unknown uniformity. Missing data were imputed for seven variables, representing 239,792 responses and up to 64.4% of total cases within those variables. Variables representing less than 5% of residents were removed. The final model explained 13.6% of the variance in falls. Environmental and contextual factors were not available in the dataset. Some narrative results and Table 1 or Table 2 disagree, including frequencies and confidence intervals, so exact figures need checking.
Declared interests
The authors declare no conflicts of interest. Data were provided by the Canadian Institute of Health Information.
The easy way to misread this
Do not read these associations as proof that changing a risk factor prevents falls. The study is cross-sectional, and a recent fall may have changed the resident's recorded condition.