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). CONCLUSIONS 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.