Psychological Rather Than Cognitive Status Associated With Incorrect Perception of Falling Risk in Dementia Patients

According to Medical Xpress , a new study suggests that psychological forces like anxiety or fear of falling, cognitive sub-performances like executive functions, and behavioral indicators such as support seeking and interplay with other risk variables should be factored into documented risk of falling in persons with disabilities (PWD). "PWD show a threefold incidence of falls and a doubled incidences of severe falls as compared to peers without dementia, and an inaccurate risk-perception and associated behavioral consequences may represent a link to this traumatic event in old age," said Heidelberg University's Klaus Hauer, as reported in the Journal of Alzheimer's Disease . Persons with neurodegenerative diseases often exhibit poor self-awareness that may worsen already compromised decision-making and behavior. However, psychological- or functional status or adaptive behavioral strategies have been strongly associated with incorrect fall risk perception in study samples that lack cognitive impairment or unspecified cognitive status. Those factors may interfere with, enable, offset, or superimpose the effects of impaired cognition. "Study results indicate that cognitive impairment per se does not lead to underestimation of risk of falling while results of specific cognitive subdomains such as less impaired executive and memory function was only associated with overestimation of risk in this group of persons with beginning to moderate stage dementia," explained Heidelberg's Ilona Dutzi. "Other factors such as anxiety, concerns about falling, activity avoidance, history of falls, or support-seeking strategies represented more relevant parameters to discriminate between match or mismatch of objective versus subjective risk of falling."