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Incidence and prediction of falls in dementia: a prospective study in older people


Allan, Louise M., Ballard, Clive G., Rowan, Elise N., Kenny, Rose Anne


Plos One, Volume: 4, No.: 5, Pages.: e5521-e5521

Year of Publication



Background: Falls are a major cause of morbidity and mortality in dementia, but there have been no prospective studies of risk factors for falling specific to this patient population, and no successful falls intervention/prevention trials. This prospective study aimed to identify modifiable risk factors for falling in older people with mild to moderate dementia.; Methods and Findings: 179 participants aged over 65 years were recruited from outpatient clinics in the UK (38 Alzheimer’s disease (AD), 32 Vascular dementia (VAD), 30 Dementia with Lewy bodies (DLB), 40 Parkinson’s disease with dementia (PDD), 39 healthy controls). A multifactorial assessment of baseline risk factors was performed and fall diaries were completed prospectively for 12 months. Dementia participants experienced nearly 8 times more incident falls (9118/1000 person-years) than controls (1023/1000 person-years; incidence density ratio: 7.58, 3.11-18.5). In dementia, significant univariate predictors of sustaining at least one fall included diagnosis of Lewy body disorder (proportional hazard ratio (HR) adjusted for age and sex: 3.33, 2.11-5.26), and history of falls in the preceding 12 months (HR: 2.52, 1.52-4.17). In multivariate analyses, significant potentially modifiable predictors were symptomatic orthostatic hypotension (HR: 2.13, 1.19-3.80), autonomic symptom score (HR per point 0-36: 1.055, 1.012-1.099), and Cornell depression score (HR per point 0-40: 1.053, 1.01-1.099). Higher levels of physical activity were protective (HR per point 0-9: 0.827, 0.716-0.956).; Conclusions: The management of symptomatic orthostatic hypotension, autonomic symptoms and depression, and the encouragement of physical activity may provide the core elements for the most fruitful strategy to reduce falls in people with dementia. Randomised controlled trials to assess such a strategy are a priority.;

Bibtex Citation

@article{Allan_2009, doi = {10.1371/journal.pone.0005521}, url = {}, year = 2009, month = {may}, publisher = {Public Library of Science ({PLoS})}, volume = {4}, number = {5}, pages = {e5521}, author = {Louise M. Allan and Clive G. Ballard and Elise N. Rowan and Rose Anne Kenny}, editor = {Bernhard Baune}, title = {Incidence and Prediction of Falls in Dementia: A Prospective Study in Older People}, journal = {{PLoS} {ONE}} }


accidental falls, accidents home, aged, alzheimer disease, cohort studies, dementia, dementia vascular, epidemiology, female, humans, incidence, longitudinal studies, male, parkinson disease, prevention & control, risk factors

Countries of Study


Types of Dementia

Alzheimer’s Disease, Lewy-Body, Parkinson’s Dementia, Vascular Dementia

Types of Study

Cohort Study

Type of Outcomes

Prevention and/or management of co-morbidities



Type of Interventions

Treatment/prevention of co-morbidities or additional risks


Fall Prevention