People withAlzheimer’sandother types of dementiatend to be at a high risk of falling. They are more than three times more likely to fracture their hip when they fall, which leads to surgery and immobility. The rate of death following ahip fracturefor those with Alzheimer’s is also increased.Thus, fall prevention for people withdementiais critical.
One way to reduce falls in people with dementia is to understand why they fall. If we know what makes our loved ones more likely to fall, we can try to anticipate those needs and decreasefalls.
Laura Porter / Verywell
Causes of Falls
These factors are the most common causes of falls in people with dementia.
Physical Weakness, Gait Changes, and Poor Balance
Some people in the early stages of Alzheimer’s are in excellent physical shape and walk for miles every day, while others seem to develop difficulties almost beforememory problemsbegin. Some research even suggests that adecline in gait(the way a person moves their legs when they walk) or balance can be an early indicator of a decline in cognition. As Alzheimer’s progresses into themiddle stagesandlater stages, it causes a decline in muscle strength, walking, and balance.
Lack of Physical Exercise
Exacerbating the above, some individuals aren’t getting enoughphysical activity. Thebenefits of physical exercise in dementiaare many and can include increased daily functioning and improved cognition.
Memory Impairment
As Alzheimer’s progresses, keeping loved ones from falling can become increasingly difficult, in part because of the cognitive decline associated with the disease. For example, even though you might explain to your husband that he shouldn’t get up out of his chair without help because hismemory is impaired, he may continually try to walk independently when he’s not safe to do so. He’s been walking when he wanted to his whole life, so to remember now that he is not strong or steady enough to do this can be a difficult change.
Poor Judgment
Sometimes, falls occur because of poor decision-making skills, such as attempting to walk alone down the steps or outside in the middle of winter on ice.
Impaired Judgment in Dementia
Visual-Spatial Problems
Because Alzheimer’s can affect visuospatial abilities, a person can misinterpret what he sees and misjudge steps, uneven terrain, shiny areas on the floor, or changes in floor color. Be sure to have his vision checked regularly, as eyesight can decline in the aging process. For example, poor vision could prevent him from seeing the paper that fell onto the floor which could cause him to slip and fall when he steps on it.
How Dementia Affects Visual-spatial Abilities
Clutter
Falls sometimes happen because of less than ideal home conditions, such as too much clutter to try to navigate around. Some people with dementia have a tendency tohoardthings which can increase the risk of tripping.
Fatigue
Some falls happen at a certain time of the day, such as in the evening before bed when your loved one is tired from the day.
Medication Side Effects
Some medications can increase the risk of falls.Antipsychotic medications, for example, can sometimes have a side effect oforthostatic hypotension, where a person experiences a sudden drop in blood pressure if they stand up too quickly.
Other medications, such as hypnotics (medications that facilitate sleep) can also cause lingering drowsiness that can increase the chance of falls. Medications that work to lower blood pressure (called antihypertensives) can cause dizziness.
Other Contributors to Falls
These factors may lead to an increased risk of falls.
Restlessness
Does his body need to be stretched out and exercised? Perhaps he’s trying to get out his chair because he really should be moving about and he hasn’t had the opportunity to do so safely. Make sure your loved one has adequate physical exercise and changes his position enough. If you’re not strong enough to help him do this safely, consider havinghome health care or other help in the hometo accomplish this.
Discomfort or Pain
Is he in pain or is he uncomfortable? Be sure toevaluate the possibility of pain, rather than just telling him to sit back down. Some people with dementia aren’t able to adequately express pain or discomfort verbally, but you may be able to see a grimace or notice a sigh or groan. If pain is an issue, you may be able to alleviate it through a different position or some medication.
Hunger or Thirst
Sometimes, a person tries to get up even if he’s too weak because he’s hungry or thirsty. If this is a trigger for your loved one, be sure to offer him plenty to drink and eat so that this need is met for him.
A Need to Use the Bathroom
Boredom
Is he just looking for something to do? Boredom is a frequent problem for people with dementia. They no longer go to work or have a long list of things to accomplish in a specific time. If he’s falling because he’swanderingaround and bored, you can try someideas for meaningful activities.
Loneliness
A Word From Verywell
Looking at the various causes of falls can increase awareness and hopefully prevent some falls from happening. If falls do occur, aroot cause analysiscan help determine what may have triggered the fall and shed light on how to prevent a future fall. These proactive approaches to fall prevention are an important aspect of providing quality care for older adults living with dementia.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Baker NL, Cook MN, Arrighi HM, Bullock R.Hip fracture risk and subsequent mortality among Alzheimer’s disease patients in the United Kingdom, 1988-2007.Age Ageing. 2011;40(1):49-54.doi:10.1093/ageing/afq146Byun S, Han JW, Kim TH, et al.Gait Variability Can Predict the Risk of Cognitive Decline in Cognitively Normal Older People.Dement Geriatr Cogn Disord. 2018;45(5-6):251-261. doi:10.1159/000489927Du Z, Li Y, Li J, Zhou C, Li F, Yang X.Physical activity can improve cognition in patients with Alzheimer’s disease: a systematic review and meta-analysis of randomized controlled trials.Clin Interv Aging. 2018;13:1593–1603. doi:10.2147/CIA.S169565Quental NBM, Brucki SMD, Bueno OFA.Visuospatial function in early Alzheimer’s disease: Preliminary study.Dement Neuropsychol. 2009;3(3):234–240. doi:10.1590/S1980-57642009DN30300010Jana AK, Praharaj SK, Roy N.Olanzapine-induced Orthostatic Hypotension.Clin Psychopharmacol Neurosci. 2015;13(1):113–114. doi:10.9758/cpn.2015.13.1.113Additional ReadingFischer Center for Alzheimer’s Research Foundation.People With Alzheimer’s at High Risk of Falls and Injury.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Baker NL, Cook MN, Arrighi HM, Bullock R.Hip fracture risk and subsequent mortality among Alzheimer’s disease patients in the United Kingdom, 1988-2007.Age Ageing. 2011;40(1):49-54.doi:10.1093/ageing/afq146Byun S, Han JW, Kim TH, et al.Gait Variability Can Predict the Risk of Cognitive Decline in Cognitively Normal Older People.Dement Geriatr Cogn Disord. 2018;45(5-6):251-261. doi:10.1159/000489927Du Z, Li Y, Li J, Zhou C, Li F, Yang X.Physical activity can improve cognition in patients with Alzheimer’s disease: a systematic review and meta-analysis of randomized controlled trials.Clin Interv Aging. 2018;13:1593–1603. doi:10.2147/CIA.S169565Quental NBM, Brucki SMD, Bueno OFA.Visuospatial function in early Alzheimer’s disease: Preliminary study.Dement Neuropsychol. 2009;3(3):234–240. doi:10.1590/S1980-57642009DN30300010Jana AK, Praharaj SK, Roy N.Olanzapine-induced Orthostatic Hypotension.Clin Psychopharmacol Neurosci. 2015;13(1):113–114. doi:10.9758/cpn.2015.13.1.113Additional ReadingFischer Center for Alzheimer’s Research Foundation.People With Alzheimer’s at High Risk of Falls and Injury.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Baker NL, Cook MN, Arrighi HM, Bullock R.Hip fracture risk and subsequent mortality among Alzheimer’s disease patients in the United Kingdom, 1988-2007.Age Ageing. 2011;40(1):49-54.doi:10.1093/ageing/afq146Byun S, Han JW, Kim TH, et al.Gait Variability Can Predict the Risk of Cognitive Decline in Cognitively Normal Older People.Dement Geriatr Cogn Disord. 2018;45(5-6):251-261. doi:10.1159/000489927Du Z, Li Y, Li J, Zhou C, Li F, Yang X.Physical activity can improve cognition in patients with Alzheimer’s disease: a systematic review and meta-analysis of randomized controlled trials.Clin Interv Aging. 2018;13:1593–1603. doi:10.2147/CIA.S169565Quental NBM, Brucki SMD, Bueno OFA.Visuospatial function in early Alzheimer’s disease: Preliminary study.Dement Neuropsychol. 2009;3(3):234–240. doi:10.1590/S1980-57642009DN30300010Jana AK, Praharaj SK, Roy N.Olanzapine-induced Orthostatic Hypotension.Clin Psychopharmacol Neurosci. 2015;13(1):113–114. doi:10.9758/cpn.2015.13.1.113
Baker NL, Cook MN, Arrighi HM, Bullock R.Hip fracture risk and subsequent mortality among Alzheimer’s disease patients in the United Kingdom, 1988-2007.Age Ageing. 2011;40(1):49-54.doi:10.1093/ageing/afq146
Byun S, Han JW, Kim TH, et al.Gait Variability Can Predict the Risk of Cognitive Decline in Cognitively Normal Older People.Dement Geriatr Cogn Disord. 2018;45(5-6):251-261. doi:10.1159/000489927
Du Z, Li Y, Li J, Zhou C, Li F, Yang X.Physical activity can improve cognition in patients with Alzheimer’s disease: a systematic review and meta-analysis of randomized controlled trials.Clin Interv Aging. 2018;13:1593–1603. doi:10.2147/CIA.S169565
Quental NBM, Brucki SMD, Bueno OFA.Visuospatial function in early Alzheimer’s disease: Preliminary study.Dement Neuropsychol. 2009;3(3):234–240. doi:10.1590/S1980-57642009DN30300010
Jana AK, Praharaj SK, Roy N.Olanzapine-induced Orthostatic Hypotension.Clin Psychopharmacol Neurosci. 2015;13(1):113–114. doi:10.9758/cpn.2015.13.1.113
Fischer Center for Alzheimer’s Research Foundation.People With Alzheimer’s at High Risk of Falls and Injury.
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