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Falls and fractures in patients with Alzheimer-type dementia
Buchner DM, Larson EB.. JAMA, 1987-03-01
Topic: Risk, prevention and care in population studies
Plain-language summary
The prevention of fall-related injuries in patients with Alzheimer-type dementia (ATD) is hampered by an incomplete understanding of their causes. We studied falls and fractures in 157 ATD patients, including 117 with three-year follow-up. Initially all but one patient could walk; 31% reported falls. During follow-up, 50% either fell or became unable to walk. The fracture rate during follow-up (69/1000/y) was more than three times the age- and sex-adjusted fracture rate in the general population. Features of both ATD and comorbid conditions contributed to the risk of falls and fractures. In particular, patients who experienced toxic reactions to drugs on entry into the study were more likely to report they had fallen prior to entry (odds ratio, 4.9; 95% confidence interval, 1.78 to 13.3), and patients who wandered were more likely to sustain fractures (odds ratio, 3.6; 95% confidence interval, 1.25 to 10.4) during the follow-up period, including hip fractures for which the odds ratio of 6.9 (95% confidence interval, 1.66 to 28.6) was unexpectedly high. Preventive measures may be possible, including controlling wandering, avoiding toxic reactions to drugs, and treating comorbid illnesses.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Buchner, D. M., & Larson, E. B. (1987). Falls and fractures in patients with Alzheimer-type dementia. JAMA. https://doi.org/10.1001/jama.1987.03390110068028
Vancouver
Buchner DM, Larson EB. Falls and fractures in patients with Alzheimer-type dementia. JAMA. 1987. doi:10.1001/jama.1987.03390110068028. PMID: 3820464.
BibTeX
@article{buchner1987-3820464,
author = {Buchner, D. M. and Larson, E. B.},
title = {{Falls and fractures in patients with Alzheimer-type dementia}},
journal = {JAMA},
year = {1987},
doi = {10.1001/jama.1987.03390110068028},
pmid = {3820464},
url = {https://doi.org/10.1001/jama.1987.03390110068028}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- During follow-up, 50% either fell or became unable to walk.
- The fracture rate during follow-up (69/1000/y) was more than three times the age- and sex-adjusted fracture rate in the general population.
- Features of both ATD and comorbid conditions contributed to the risk of falls and fractures.
- In particular, patients who experienced toxic reactions to drugs on entry into the study were more likely to report they had fallen prior to entry (odds ratio, 4.9; 95% confidence interval, 1.78 to 13.3), and patients who wandered were more likely to sustain fractures (odds ratio, 3.6; 95% confidence interval, 1.25 to 10.4) during the follow-up period, including hip fractures for which the odds ratio of 6.9 (95% confidence interval, 1.66 to 28.6) was unexpectedly high.
- Preventive measures may be possible, including controlling wandering, avoiding toxic reactions to drugs, and treating comorbid illnesses.
Why it matters
Among 157 patients with Alzheimer-type dementia, half either fell or became unable to walk during follow-up, and their fracture rate was more than three times that of the general population. The authors suggest that controlling wandering, avoiding toxic drug reactions, and treating other illnesses may help prevent falls and fractures in this group.
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Study details
- Evidence strengthLow
How this study scored 52/100
Published in a top-tier journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it. We have no data on institution's track record, so that was left out: it earned 50 of the 97 points we could judge it on, which is 52 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (JAMA) |
| Journal's citation record | 4 / 4 | JAMA: journal h-index 1,011 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 1987 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 482 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 11.8 citations a year over 41 year(s) since 1987 |
| Impact for its field and year | 6 / 6 | Cited 41.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 16 other studies in this library |
| Still being cited | 1 / 4 | Cited 12 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author David M. Büchner: h-index 74 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 3820464) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 50 / 97 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 50 of the 97 points we could judge it on is 52 out of 100. |
| Total | 52 / 100 | — |
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