Abstract：
OBJECTIVE: Little is known about how to prevent falls in community-dwelling older people with dementia. Although their care partners adopt various behaviors to prevent their falls, it is unclear if these behaviors reduce falls for those with different levels of fall risk.
METHODS: Linking the 2015 and 2016 National Health and Aging Trends Study (NHATS) and the 2015 National Study of Caregiving (NSOC), we identified 390 community-dwelling older people with dementia with 607 care partners. We selected 26 NSOC items representing fall risk management (FRM) behaviors. We examined the prevalence and dimensionality of these behaviors and investigated associations between care partners\' behaviors in 2015 (T1) and older people\'s falls in 2016 (T2) stratified by their fall incidence at T1, adjusting for covariates.
RESULTS: Five domains of FRM were identified: mobility and safety assistance, medical service coordination, health management, social service coordination, and accommodation. For those who did not fall at T1, mobility and safety assistance and social service coordination were each associated with an increased risk of falling at T2 (adjusted incidence rate ratio [aIRR]=1.39, 95% confidence interval [CI]=1.06-1.83, p=0.019, aIRR=1.25, 95% CI=1.01-1.55, p=0.043). For those who had fallen at T1, social service coordination was associated with a decreased risk of falling at T2 (aIRR=0.83, 95% CI=0.73-0.94, p=0.004).
CONCLUSIONS: The different impacts of dementia care partners\' FRM behaviors emphasize the need to address specific behaviors when involving care partners in preventing falls for older people with dementia at varying levels of fall risk.
METHODS: Linking the 2015 and 2016 National Health and Aging Trends Study (NHATS) and the 2015 National Study of Caregiving (NSOC), we identified 390 community-dwelling older people with dementia with 607 care partners. We selected 26 NSOC items representing fall risk management (FRM) behaviors. We examined the prevalence and dimensionality of these behaviors and investigated associations between care partners\' behaviors in 2015 (T1) and older people\'s falls in 2016 (T2) stratified by their fall incidence at T1, adjusting for covariates.
RESULTS: Five domains of FRM were identified: mobility and safety assistance, medical service coordination, health management, social service coordination, and accommodation. For those who did not fall at T1, mobility and safety assistance and social service coordination were each associated with an increased risk of falling at T2 (adjusted incidence rate ratio [aIRR]=1.39, 95% confidence interval [CI]=1.06-1.83, p=0.019, aIRR=1.25, 95% CI=1.01-1.55, p=0.043). For those who had fallen at T1, social service coordination was associated with a decreased risk of falling at T2 (aIRR=0.83, 95% CI=0.73-0.94, p=0.004).
CONCLUSIONS: The different impacts of dementia care partners\' FRM behaviors emphasize the need to address specific behaviors when involving care partners in preventing falls for older people with dementia at varying levels of fall risk.
摘要：
目的：关于如何预防社区居住的老年痴呆症患者跌倒的问题知之甚少。尽管他们的护理伙伴采取各种行为来防止他们跌倒，目前尚不清楚这些行为是否能减少不同跌倒风险水平的人的跌倒。
方法：将2015年和2016年国家健康与老龄化趋势研究（NHATS）与2015年国家护理研究（NSOC）联系起来，我们确定了390名社区居住的老年痴呆症患者和607名护理伙伴.我们选择了26个代表跌倒风险管理(FRM)行为的NSOC项目。我们检查了这些行为的患病率和维度，并调查了2015年（T1）护理伙伴行为与2016年（T2）老年人跌倒之间的关联，并根据T1时的跌倒发生率进行了分层，并调整了协变量。
结果：确定了FRM的五个领域：行动和安全援助，医疗服务协调，健康管理,社会服务协调，和住宿。对于没有在T1时跌倒的人，行动和安全援助以及社会服务协调均与在T2时跌倒的风险增加相关（调整后的发生率比率[aIRR]=1.39，95％置信区间[CI]=1.06-1.83，p=0.019，aIRR=1.25，95％CI=1.01-1.55，p=0.043）。对于T1时跌倒的人，社会服务协调与T2时跌倒的风险降低相关（aIRR=0.83，95％CI=0.73-0.94，p=0.004）。
结论：痴呆症护理伙伴的不同影响“FRM行为强调，当护理伙伴参与预防不同跌倒风险水平的痴呆症老年人跌倒时，需要解决特定行为。
方法：将2015年和2016年国家健康与老龄化趋势研究（NHATS）与2015年国家护理研究（NSOC）联系起来，我们确定了390名社区居住的老年痴呆症患者和607名护理伙伴.我们选择了26个代表跌倒风险管理(FRM)行为的NSOC项目。我们检查了这些行为的患病率和维度，并调查了2015年（T1）护理伙伴行为与2016年（T2）老年人跌倒之间的关联，并根据T1时的跌倒发生率进行了分层，并调整了协变量。
结果：确定了FRM的五个领域：行动和安全援助，医疗服务协调，健康管理,社会服务协调，和住宿。对于没有在T1时跌倒的人，行动和安全援助以及社会服务协调均与在T2时跌倒的风险增加相关（调整后的发生率比率[aIRR]=1.39，95％置信区间[CI]=1.06-1.83，p=0.019，aIRR=1.25，95％CI=1.01-1.55，p=0.043）。对于T1时跌倒的人，社会服务协调与T2时跌倒的风险降低相关（aIRR=0.83，95％CI=0.73-0.94，p=0.004）。
结论：痴呆症护理伙伴的不同影响“FRM行为强调，当护理伙伴参与预防不同跌倒风险水平的痴呆症老年人跌倒时，需要解决特定行为。
