A Population-Based Study Examining Injury in Older Adults with and without Dementia

OBJECTIVES: To estimate the incidence of and risk factors for injuries in older adults with and without dementia.

DESIGN: Retrospective, population-based cohort study.

SETTING: Western Australian Data Linkage System (WADLS).

PARTICIPANTS: Cases included 29,671 (47.9%) older adults aged 50 and older with an index hospital admission for dementia between 2001 and 2011. Comparison participants without dementia included a random sample of 32,277 (52.1%) older adults aged 50 and older from the state electoral roll.

MEASUREMENTS: Hospital admission to a metropolitan tertiary hospital for at least 24 hours with an injury.

RESULTS: Age-standardized all-cause injury rates for older adults with dementia (≥60) were 117 per 1,000 population and 24 per 1,000 population for older adults without dementia. Falls caused the majority of injuries for both groups (dementia, 94%; without dementia, 87%), followed by transport-related injuries and burns. Multivariate modeling found that older adults with a diagnosis of dementia had more than twice the risk of hospital admission for an injury than those without dementia (incidence rate ratio (IRR) = 2.05, 95% confidence interval (CI) = 1.96–2.15). Other significant risk factors for a hospital admission for injury were age 85 and older (IRR = 1.43, 95% CI = 1.13–1.81), being unmarried (IRR = 1.07, 95% CI = 1.03–1.12), and a history of falls (IRR = 1.03, 95% CI = 1.01–1.06). Women were at lower risk then men of a hospital admission due to an injury (IRR = 0.92, 95% CI = 0.87–0.97).

CONCLUSION: Older adults with dementia are at greater risk of a hospital admission for an injury. Multifactorial injury prevention programs would benefit older adults with and without dementia, especially those aged 85 and older, living alone, and with a history of previous falls.