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FALLS AND FEAR OF FALLING IN NURSING HOME RESIDENTS WITH HUNTINGTON’S DISEASE

K. Kalkers, J.C.L. Neyens, R. Wolterbeek, R.J.G. Halfens, J.M.G.A. Schols, R.A.C. Roos

Jour Nursing Home Res 2016;2:83-89

Background: Almost half of nursing home residents with Huntington’s disease experience fall incidents. There is little knowledge about fear of falling in patients with Huntington’s disease. Objectives: To explore incidence of falling and the association with fear of falling in nursing home residents with Huntington’s disease compared to other nursing home residents. A secondary objective is to explore changes in incidence of falling and prevalence of fear of falling in a 24-month follow-up period in a subgroup of longitudinally followed HD-residents. Design: Cross-sectional multi-centre point prevalence study of relevant care problems including falls, known as the Dutch National Prevalence Measurement of Care Problems in 2012, 2013 and 2014. Setting: Eight Dutch nursing homes belonging to one organization. One of these nursing homes cares exclusively for Huntington residents. Participants: 57 Huntington residents and 404 non-Huntington residents were included over a two-year period; 30 Huntington residents participated in three consecutive measurements. Measurements: Residents’ characteristics, fall incidence and health problems after a fall were prospectively assessed for 30 days. Fear of falling and avoiding activities were measured by a single-item question. Results: The percentage of fallers among the Huntington residents (30%) was significantly higher (p<0.001) compared to the non-Huntington residents (10%). The percentage of Huntington residents expressing fear of falling was significantly lower (p<0.05, 14% versus 30%). Logistic regression analysis revealed that interaction between the Huntington and non-Huntington group and age was significant (odds ratio 0.91, p-value 0.02). Fewer Huntington residents than non-Huntington residents experienced fear of falling, a difference which increased with age. The percentages of avoiding activities did not differ between the two groups. Huntington residents were more care-dependent than non-Huntington residents. Huntington versus non-Huntington residents and care dependency were significant predictors for avoiding activities, after controlling for resident characteristics. A cohort of 30 Huntington residents followed longitudinally for 24 months showed significant changes in fear of falling: an increase in the first 12 months and a decrease in the second 12 months. Conclusions: Although fall incidents were more common in Huntington residents than in non-Huntington residents, Huntington residents were less fearful of falling. Possible explanatory factors are age and care dependency. Future research should include cognitive functioning and insight into deficits as factors possibly contributing to fear of falling.

CITATION:
K. Kalkers ; J.C.L. Neyens ; R. Wolterbeek ; R.J.G. Halfens ; J.M.G.A. Schols ; R.A.C. Roos (2016): Falls and Fear of Falling in Nursing Home Residents with Huntington’s Disease. The Journal of Nursing Home Research Science (JNHRS). http://dx.doi.org/10.14283/jnhrs.2016.12

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