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Evidence for environmental and behavioral contributors is still limited compared with well-established physiological factors. A cross-sectional analysis used the Chengdu Long-term Care Insurance (LTCI) database from 2018 to 2022 to assess fall risk in older adults with moderate-to-severe dementia. Univariate and multivariate logistic regression examined how residential environment, physical function, and neuropsychiatric symptoms relate to falls. Among 5,806 participants (median age 82.0 years), living at home increased fall risk versus skilled nursing facilities (aOR 2.15). Additional independent risk factors included aphasia, dysphagia, hallucinations/delusions, genitourinary disorders, and rheumatic autoimmune diseases, while mental illness showed lower risk. Findings support systematic fall-risk assessment and prevention that incorporates residential environment, neuropsychiatric symptoms, and functional impairments to improve patient safety, service quality, and reduce caregiver burden.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/risk-factors-for-falls-in-elderly-patients-with-moderate-to-severe-dementia-abstract-citation-id-igaf1223841-cross-sectional-study-using-chengdu-ltci-database-20182022/426260/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/risk-factors-for-falls-in-elderly-patients-with-moderate-to-severe-dementia-abstract-citation-id-igaf1223841-cross-sectional-study-using-chengdu-ltci-database-20182022/426260.png","ImageObject",300,407,{"name":92,"@type":93},"supergirl","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-28",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What data source and time period were used to evaluate fall risk?","Question",{"text":112,"@type":113},"The study used the Chengdu Long-term Care Insurance (LTCI) database covering 2018–2022.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which living setting showed a higher fall risk?",{"text":117,"@type":113},"Participants living at home had a significantly higher risk of falls than those in skilled nursing facilities (aOR 2.15).",{"name":119,"@type":110,"acceptedAnswer":120},"What factors should be incorporated into fall-risk assessment for moderate-to-severe dementia?",{"text":121,"@type":113},"Fall-risk assessment and prevention should systematically include residential environment, neuropsychiatric symptoms, and functional impairments.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},426260,1790741772,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":24},962088121634,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Innovation in Aging, 2025, Vol. 9, No. S2 1145  \nAbstract citation ID: igaf122.3841  \nRISK FACTORS FOR FALLS IN ELDERLY PATIENTS WITH MODERATE-TO-SEVERE DEMENTIA.  \nHuixian Li, Tianyi Luo, and Yanyan Wang, West China Hospital, Sichuan University, Chengdu, Sichuan, China  \n(People’s Republic)  \nDementia is a progressive neurodegenerative disease that affects millions of older adults worldwide, leading to cognitive and functional decline and significantly increases the risk of falls. While physiological risk factors are well documented, evidence on environmental and behavioral contributors remains limited.  \n1146 Innovation in Aging, 2025, Vol. 9, No. S2  \nUsing data from the Chengdu Long-term Care Insurance (LTCI) database (2018–2022), we conducted a cross-sectional study to evaluate factors influencing fall risk among older adults with moderate-to-severe dementia. We applied univariate and multivariate logistic regression analyses to examine the associations of residential environment, physical function, and neuropsychiatric symptoms with fall risk. A total of 5,806 participants were included, with a median age of 82.0 years (IQR, 76.0–87.0); 62.2% were female. Multivariate logistic regression analyses showed that participants living at home, compared with those in skilled nursing facilities, had a significantly higher risk of falls (adjusted odds ratio [aOR] = 2.15, 95% CI: 1.60–2.89) . Other independent risk factors included aphasia (aOR = 2.11 [1.67–2.66]), dysphagia (aOR = 1.69 [1.32–2.17]), hallucinations/delusions (aOR = 1.30 [1.04–1.62]), genitourinary disorders (aOR = 1.36 [1 .08–1.71]), and rheumatic autoimmune diseases (aOR = 1.31 [1.02–1.68]) . Notably, participants with mental illness had a lower risk of falls (aOR = 0.53 [0 .43–0.66]), which may reflect more intensive medical care and management in this population. Our findings indicate that fall risk assessment and prevention for individuals with moderate-to-severe dementia should systematically incorporate residential environment, neuropsychiatric symptoms, and functional impairments. Addressing these factors is essential for improving patient safety, ensuring high-quality medical services, and reducing caregiver burden.","cbCaigWzgEjsqfZR","https://ap.wps.com/l/cbCaigWzgEjsqfZR","pdf",1970358,"English","# Abstract\n## Study design and data source\n## Statistical methods\n## Participant characteristics\n## Key risk factors and adjusted odds ratios\n## Implications for fall prevention","[{\"question\":\"What data source and time period were used to evaluate fall risk?\",\"answer\":\"The study used the Chengdu Long-term Care Insurance (LTCI) database covering 2018–2022.\"},{\"question\":\"Which living setting showed a higher fall risk?\",\"answer\":\"Participants living at home had a significantly higher risk of falls than those in skilled nursing facilities (aOR 2.15).\"},{\"question\":\"What factors should be incorporated into fall-risk assessment for moderate-to-severe dementia?\",\"answer\":\"Fall-risk assessment and prevention should systematically include residential environment, neuropsychiatric symptoms, and functional impairments.\"}]","RISK FACTORS FOR FALLS IN ELDERLY PATIENTS WITH MODERATE-TO-SEVERE DEMENTIA - Abstract citation ID igaf122.3841 - Cross-sectional study using Chengdu LTCI database (2018–2022) | PDF",1790639997]