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Risk of Dementia Diagnosis After Injurious Falls in Older Adults
Ordoobadi AJ, Dhanani H, Tulebaev SR, Salim A, Cooper Z, Jarman MP. JAMA Network Open, 2024-09-03
Topic: Risk, prevention and care in population studies
Importance Emerging evidence suggests that mild cognitive impairment, which is a precursor to Alzheimer disease and related dementias (ADRD), places older adults at increased risk for falls. However, the risk that an older adult develops dementia after experiencing a fall is unknown. Objective To determine the risk of new ADRD diagnosis after a fall in older adults. Design, setting, and participants This retrospective cohort study examined Medicare Fee-for-Service data from 2014 to 2015, with follow-up data available for at least 1 year after the index encounter. Participants included adults aged 66 years and older who experienced a traumatic injury that resulted in an emergency department (ED) or inpatient encounter and did not have a preexisting diagnosis of dementia. Data analysis was performed from August 2023 to July 2024. Exposures Experiencing a fall compared with other mechanisms of injury, defined by International Classification of Diseases, Ninth Revision (ICD-9) and ICD-10 external cause of injury codes. Main outcomes and measures The hazard of new ADRD diagnosis within 1 year of a fall, assessed by performing a Cox multivariable competing risk model that controlled for potential confounders while accounting for the competing risk of death. Results The study included 2 453 655 older adult patients who experienced a traumatic injury; 1 522 656 (62.1%) were female; 124 396 (5.1%) were Black and 2 232 102 (91.0%) were White; and the mean (SD) age was 78.1 (8.1) years. The mechanism of injury was a fall in 1 228 847 incidents (50.1%). ADRD was more frequently diagnosed within 1 year of a fall compared with other injury mechanisms (10.6% [129 910 of 1 228 847] vs 6.1% [74 799 of 1 224 808]; P Conclusions and relevance In this cohort study, new ADRD diagnoses were more common after falls compared with other mechanisms of injury, with 10.6% of older adults being diagnosed with ADRD in the first year after a fall. To improve the early identification of ADRD, this study's findings suggest support for the implementation of cognitive screening in older adults who experience an injurious fall that results in an ED visit or hospital admission.
Key findings
- Importance Emerging evidence suggests that mild cognitive impairment, which is a precursor to Alzheimer disease and related dementias (ADRD), places older adults at increased risk for falls.
- Exposures Experiencing a fall compared with other mechanisms of injury, defined by International Classification of Diseases, Ninth Revision (ICD-9) and ICD-10 external cause of injury codes.
- Results The study included 2 453 655 older adult patients who experienced a traumatic injury; 1 522 656 (62.1%) were female; 124 396 (5.1%) were Black and 2 232 102 (91.0%) were White; and the mean (SD) age was 78.1 (8.1) years.
- ADRD was more frequently diagnosed within 1 year of a fall compared with other injury mechanisms (10.6% [129 910 of 1 228 847] vs 6.1% [74 799 of 1 224 808]; P < .001).
- To improve the early identification of ADRD, this study's findings suggest support for the implementation of cognitive screening in older adults who experience an injurious fall that results in an ED visit or hospital admission.
Why it matters
This cohort study examined the risk of a new dementia diagnosis within one year after an injurious fall in older adults without preexisting dementia. The text provided does not report the study's results, so no conclusion about falls and dementia risk can be drawn.
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Study details
- Study designcohort
- Participants2,453,655
- Effect sizeAdjusted HR 1.21 (95% CI 1.20-1.21) for new dementia diagnosis within 1 year after a fall vs other injury
- Evidence strengthModerate
Limitations
Falls may be caused by undiagnosed dementia already present (the study identifies detection opportunity rather than causation); claims-based diagnoses; fee-for-service Medicare only.
How this study scored 65/100
Published in a leading specialty journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it. We have no data on free to read, so that was left out: it earned 64 of the 98 points we could judge it on, which is 65 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (JAMA Network Open) |
| Journal's citation record | 2 / 4 | JAMA Network Open: journal h-index 235 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2024 — within 3 year(s) of the newest study here |
| Sample size | 4 / 4 | 2,453,655 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 3 / 7 | Cited 26 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 6.5 citations a year over 4 year(s) since 2024 |
| Impact for its field and year | 3 / 6 | Cited 7.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 3 other studies in this library |
| Still being cited | 2 / 4 | Cited 26 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Molly Price Jarman: h-index 25 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Brigham and Women's Hospital: institution h-index 1,995 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39348117) |
| Free to read | — / 2 | Access not recorded — left out of this score |
| Points | 64 / 98 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 64 of the 98 points we could judge it on is 65 out of 100. |
| Total | 65 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1001/jamanetworkopen.2024.36606
- PubMed: 39348117
- Original source →
- Free full text: PubMed Central →
Full text: free to read — PubMed Central lists this copy as free to read: the link above (checked 10 Oct 2026).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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.
APA 7th
Ordoobadi, A. J., Dhanani, H., Tulebaev, SR., Salim, A., Cooper, Z., & Jarman, M. P. (2024). Risk of Dementia Diagnosis After Injurious Falls in Older Adults. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2024.36606
Vancouver
Ordoobadi AJ, Dhanani H, Tulebaev SR, Salim A, Cooper Z, Jarman MP. Risk of Dementia Diagnosis After Injurious Falls in Older Adults. JAMA Network Open. 2024. doi:10.1001/jamanetworkopen.2024.36606. PMID: 39348117.
BibTeX
@article{ordoobadi2024-39348117,
author = {Ordoobadi, A. J. and Dhanani, H. and Tulebaev, SR. and Salim, A. and Cooper, Z. and Jarman, M. P.},
title = {{Risk of Dementia Diagnosis After Injurious Falls in Older Adults}},
journal = {JAMA Network Open},
year = {2024},
doi = {10.1001/jamanetworkopen.2024.36606},
pmid = {39348117},
url = {https://doi.org/10.1001/jamanetworkopen.2024.36606}
}
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