Cognitive status as a robust predictor of repeat falls in older Veterans in post-acute care

Abstract

Background While repeat falls are common in post-acute care (PAC), risk factors have not been fully elucidated. Aims The objective of thids study is to evaluate the contribution of cognitive function to repeat falls in older PAC Veterans. Methods Data were collected from medical records for 91 single and 30 repeat fallers over 5 consecutive years (2011–2016). Results After controlling for demographic and medical factors, lower Mini-Mental State Exam (MMSE) score was associated with increased odds of repeat falls. MMSE scores below 20 (with age held constant at the mean) were associated with a greater than 50% chance of a repeat fall (compared to 24.7% base rate). Admission for a neurologic reason further increased risk. Discussion PAC Veterans who experience a fall have an increased risk of repeat falls with concomitant cognitive dysfunction and/or admission for neurologic reasons. Conclusions Results support tailoring multi-component interventions for those with cognitive dysfunction utilizing standardized mental status screening upon admission.