Aim: This study aimed to determine the main risk factors for falls in patients with Alzheimer disease (AD) by comparing balance, cognition, and visuospatial ability between those who have experienced a fall and those who have not. Methods: Forty-seven AD patients were admitted to a ward for patients with dementia (22 men and 25 women). The balance of patients was evaluated using the Functional Reach Test (FRT), the one-leg standing duration, and the Timed Up and Go (TUG) test. The Mini-Mental State Examination-Japanese (MMSE-J) was used to evaluate cognition. For visuospatial ability assessment, the Clock-Drawing Test (CDT) as well as overlapping figure identification and shape discrimination in the Visual Perception Test for Agnosia (VPTA) were used. The patients were allocated to either the fall group or the nonfall group based on their history of falls in the past year. The relationships between patients’ characteristics and evaluation outcomes were compared and examined. Logistic regression analysis was performed using a fall as the objective variable. The area under the curve (AUC) and the cutoff value were calculated. Results: Of the 47 participants, 22 had experienced falls within the past year (46.8%). The results of the FRT, one-leg standing duration, the TUG, the CDT, and the VPTA were significantly lower in the fall group. No significant difference between the MMSE-J scores of the fall group and those of the nonfall group was observed. The results of the logistic regression analysis indicated that falls in AD patients were significantly associated with the FRT. It was found that a shorter FRT distance (cm) had a significant impact on falls. For the FRT, the fall-related AUC was 0.755. At a cutoff value of 24.5 cm, the level of sensitivity was 68.0%, and the level of specificity was 77.3%. Conclusions: The findings of this study indicate that balance and visuospatial abilities are risks factors for falls in AD patients. In contrast, cognitive impairment was not a risk factor for falls. It was demonstrated that the FRT could be an appropriate risk predictor for falls in AD patients. In particular, falls in AD patients were strongly affected by a reduced dynamic balance.
Dement Geriatr Cogn Disord Extra 2021;11:58–63

中文翻译：

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阿尔茨海默病患者跌倒的危险因素：平衡、认知和视觉空间能力的回顾性研究

目的：本研究旨在通过比较跌倒患者和未跌倒患者的平衡、认知和视觉空间能力，确定阿尔茨海默病 (AD) 患者跌倒的主要危险因素。方法：47 名 AD 患者入住痴呆患者病房（22 名男性和 25 名女性）。使用功能范围测试 (FRT)、单腿站立持续时间和 Timed Up and Go (TUG) 测试评估患者的平衡。简易精神状态检查-日语（MMSE-J）用于评估认知。对于视觉空间能力评估，使用了时钟绘图测试 (CDT) 以及失认症视觉感知测试 (VPTA) 中的重叠图形识别和形状辨别。根据过去一年的跌倒史，将患者分配到跌倒组或非跌倒组。比较和检查了患者特征和评估结果之间的关系。使用跌倒作为目标变量进行逻辑回归分析。结果：在 47 名参与者中，22 名在过去一年内经历过跌倒（46.8%）。跌倒组的 FRT、单腿站立时间、TUG、CDT 和 VPTA 的结果显着降低。跌倒组和非跌倒组的 MMSE-J 评分无显着差异。逻辑回归分析的结果表明，AD 患者的跌倒与 FRT 显着相关。发现较短的 FRT 距离 (cm) 对跌倒有显着影响。对于 FRT，与跌倒相关的 AUC 为 0.755。在截断值为 24.5 cm 时，敏感性水平为 68.0%，特异性水平为 77.3%。结论：这项研究的结果表明，平衡和视觉空间能力是 AD 患者跌倒的危险因素。相反，认知障碍不是跌倒的危险因素。结果表明，FRT 可能是 AD 患者跌倒的适当风险预测指标。特别是，AD 患者的跌倒受到动态平衡降低的强烈影响。
Dement Geriatr Cogn Disord Extra 2021；11：58–63