Date of Conferral

2022

Degree

Ph.D.

School

Public Health

Advisor

Richard Jimenez

Abstract

Despite the high incidence of fall among the elderly in residential care, this problem has been minimally explored and reported. This study examined the association between (cognitive performance, dementia, four groups of psychotropic medication-hypnotics, antidepressants, antianxiety medication, and antipsychotics) and fall among Canadian elderly in residential care. A multi–variate logistic regression was used for the analysis. The Social Cognitive Theory was used to interpret the findings of an analysis on 180,231 Canadian residents from 2018–2019. Cognitive performance at intact level (OR=1.114, p<0.001), cognitive performance at moderate level (OR=1.192, p<0.001), dementia diagnosis (OR=1.075, p<0.001), antipsychotics (OR=2.571, p<0.001), antidepressants (OR =1.486, p<0.001) and antianxiety prescription (OR=3.284, p<0.001) increased the odds ratio of fall. However, cognitive performance at severe level (OR=0.898, p<0.001), no dementia diagnosis (OR=0.001, p<0.001) and hypnotics prescription (OR=0.389, p<0.001) decreased the odds ratio of fall. Findings indicate that cognitive performance at the intact and moderate levels, antianxiety, antipsychotic and antidepressant medications and dementia were strong predictors of fall among the elderly in residential care in Canada. A limitation of the study was that the dataset used captured data from 7 out of 13 Canadian provinces and territories therefore, limiting external validity. The potential positive social change impact of this study is that it would guide caregivers, enhance fall prevention practices and decrease fall occurrence in this population.

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