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Published on: September 20, 2018
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Clinical Manifestations
Sena Gok1, Salma Amarin1, Nicole Schoer2
1CAMH, Toronto, ON, Canada.
Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 24, 2025
Summary
In Alzheimer's disease, functional impairment, not medication, significantly impacts fall risk in patients with neuropsychiatric symptoms. This highlights the need to focus on cognitive and functional status for fall prevention strategies.
Area of Science:
- Geriatric Medicine
- Neurology
- Clinical Pharmacology
Background:
- Polypharmacy is prevalent in older adults with Alzheimer's disease and related dementias (ADRD) experiencing neuropsychiatric symptoms (NPS).
- Medication's specific impact on fall risk in this population remains unclear despite associations with general increased fall risk.
Purpose of the Study:
- To evaluate fall risk associated with psychotropic and general medication use in patients with ADRD and NPS.
- To control for other clinical factors influencing fall risk in this cohort.
Main Methods:
- Utilized data from the Standardizing Care for Neuropsychiatric Symptoms and Quality of Life in Dementia (StaN) study.
- Assessed number of psychotropic/general medications, Cohen Mansfield Agitation Inventory (CMAI), Cumulative Illness Rating Scale-Geriatric (CIRS-G), Functional Assessment Staging Tool (FAST), and Morse Fall Scale (MFS).
- Employed linear regression analyses adjusting for age, CIRS-G, CMAI, and FAST scores to examine associations with MFS.
Main Results:
- 185 participants (mean age 80.5 years, mean FAST score 9.1) were analyzed.
- Neither psychotropic nor general medication use showed a significant association with fall risk (MFS).
- Functional Assessment Staging Tool (FAST) stage of dementia was significantly associated with fall risk.
Conclusions:
- Functional and cognitive impairment, rather than medication, appears to be a more significant influence on fall risk in Alzheimer's disease.
- Findings are specific to a cohort with severe dementia and significant NPS.
- Results may inform fall risk management strategies for similar patient populations.
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