The association between the severity of cognitive impairment and the risk of falls in patients with dementia

Background
Falls are a significant cause of morbidity and mortality in older individuals with dementia, presenting a complex and multifactorial challenge. Cognitive impairment in dementia further exacerbates this risk, as it impairs judgment, attention, and motor coordination, while also reducing the ability to recognize and avoid potential hazards in the environment.

Objectives
To investigate the association between the severity of cognitive impairment and the risk of falls in patients with dementia.

Material and methods
We conducted a cross-sectional study using a consecutive sampling method involving 30 dementia patients at the Neurology Clinic of USU Hospital in Medan Indonesia from January until July 2024. We assessed cognitive function using the Montreal Cognitive Indonesian Version (MoCA-INA) and the severity of cognitive impairment with the Clinical Dementia Rating Scale (CDR). The Timed Up and Go (TUG) test was used to evaluate the risk of falls. Data were analyzed using SPSS version 26 with a p-value < 0.05 considered significant. Results. We enrolled 30 dementia patients with a mean age of 64.3 ± 7.8 years. Half of the participants (50%) had mild dementia, and 56.7% were categorized as having a mild fall risk. We found a significant association between dementia severity and cognitive impairment with fall risk using the Kruskall-Wallis test (p = 0.036) and a one-way ANOVA test (p = 0.005), respectively.

Conclusions
Our findings indicate that the severity of cognitive impairment was significantly associated with an increased risk of falls in patients with dementia. Fall risk screening should be an integral part of the management and prevention strategies for dementia patients.