Falls and hospitalizations among persons with dementia and associated caregiver emotional difficulties
Open accessAbstract
Background and Objectives: Falls and hospitalizations are adverse health events commonly experienced by persons with dementia (PWDs). These events often require urgent care from a family caregiver and may increase caregiver stress. We examine falls and hospitalizations among PWDs as predictors of caregivers' reported care-related emotional difficulty, in addition to care-related stressors. Research Design and Methods: Cross-sectional telephone survey of 652 informal caregivers for PWDs. A multinomial logistic regression examined falls (last month) and hospitalizations (prior year) experienced by PWDs as predictors of caregivers' care-related emotional difficulty, accounting for demographic characteristics and primary and secondary caregiving stressors. Results: Over 20% of caregivers reported high levels of care-related emotional difficulty. Controlling for demographic characteristics and primary and secondary caregiving stressors, the PWD's prior month fall was significantly associated with greater care-related emotional difficulty; the PWD's hospitalizations were not associated with care-related emotional difficulty. Discussion and Implications: Approximately 30% of PWDs had experienced a past year hospitalization and prior month fall, and one in five caregivers reported high emotional difficulty related to care. Although secondary strains and resources of caregiving were strong predictors of care-related emotional difficulty, PWDs' falls represent a significant stressor that increases odds of caregiver emotional difficulty over and above other strains. Consequently, a fall experienced by a PWD may represent a key time for clinicians to assess caregiver well-being.
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People with dementia are more likely to suffer adverse events such as falls, delirium, faster cognitive decline, and permanent institutionalization.
“People with dementia are also more likely to experience other adverse events because of these acute care and post-acute utilization patterns, including falls, delirium, hastened cognitive decline and permanent institutionalization.19, 21, 22”
From Discharge Communication of Dementia-Related Neuropsychiatric Symptoms and Care Management Strategies during Hospital to Skilled Nursing Facility Transitions (2021) · cites this paper as [22]
The Falls section says people with dementia have more incident falls than age-matched controls. The Hospitalizations section lists delirium and falls as frequent reasons for admission and reports higher rates of institutionalization after discharge. It does not establish hastened cognitive decline or permanent institutionalization, or show that acute and post-acute care utilization causes all the listed events; no page numbers are available in our copy. (LLM, conf=0.86)
Experimental — accuracy not yet measuredCaregivers frequently expressed a lack of dementia-specific knowledge, which hindered their ability to anticipate care needs and make informed decisions during transitions.
“Caregivers frequently expressed a lack of dementia-specific knowledge, which hindered their ability to anticipate care needs and make informed decisions during transitions (de Vries et al., 2019; Ke-Hau et al., 2020; Leggett et al., 2018).”
From Mind the gap: a systematic review of barriers, facilitators, and experiences of care transitions for people living with dementia and their informal caregivers. (2026) · cites this paper as Leggett et al., 2018
The Current Study section (page unavailable) says falls and hospitalizations may require caregivers to make urgent medical decisions in confusing circumstances. It does not report that caregivers frequently expressed a lack of dementia-specific knowledge, or that such a lack hindered anticipation of care needs and decisions during transitions. (LLM, conf=0.78)
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- Authors
- Leggett, A. N., Polenick, C. A., Maust, D. T., & Kales, H. C.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Leggett, Amanda N
- Venue
- The Gerontologist
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-01-20
- Volume
- 58
- Issue
- 2
- Pages
- e78-e86
- ISSN
- 0016-9013 (ISSN-L)
- 1758-5341
- PMC
- PMC5946818
- OpenAlex
- W2789453343
- Cited by
- 35
- References
- 54
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 8 · 2023: 5 · 2022: 5 · 2021: 1 · 2020: 6 · 2019: 1 · 2018: 1
- FWCI
- 1.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Gerontologist (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Mental Health
- University of Michigan Program for Positive Aging (T32 MH 073553-11)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Health Sciences › Health Professions › General Health Professions › Geriatric Care and Nursing Homes
- Keywords
- dementia, falls, hospitalization, informal caregivers, caregiver stress, caregiver well-being
- MeSH terms
- Accidental Falls, Adult, Affective Symptoms, Aged, Dementia, Family, Family Health, Family Relations, Female, Hospitalization, Humans, Male, Middle Aged, Quality of Life, Social Support, Needs Assessment, Qualitative Research
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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