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Falls prevention interventions for community-dwelling older persons with cognitive impairment: a systematic review

Published online by Cambridge University Press:  09 October 2012

Heidi Winter ,
Kerrianne Watt  and
Nancye May Peel
Heidi Winter
Affiliation:
School of Population Health, The University of Queensland, Herston, Queensland 4006, Australia
Kerrianne Watt
Affiliation:
School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland 4811, Australia
Nancye May Peel*
Affiliation:
Centre for Research in Geriatric Medicine, School of Medicine, The University of Queensland, Woolloongabba, Queensland 4102, Australia
*
Correspondence should be addressed to: Dr. Nancye May Peel, Research Fellow, Centre for Research in Geriatric Medicine, The University of Queensland School of Medicine, Level 2, Building 33, Princess Alexandra Hospital, Woolloongabba QLD 4102, Australia. Phone: +61-7-3176-7402; Fax: +61-7-3176-6945. Email: n.peel@uq.edu.au.
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Abstract

Background: Globally, falls in older people are a leading cause of injury-related mortality and morbidity. Cognitive impairment is a well-known risk factor for falls in this population group. While there is now a large body of evidence to support effective interventions for falls reduction across care settings, very little is known about interventions in the vulnerable, but increasing population of cognitively impaired community-dwelling older people. Therefore, the purpose of this systematic review is to investigate interventions designed to reduce falls in community-dwelling, cognitively impaired older adults.

Methods: A literature search of databases was conducted to identify original research published in English, which met predefined inclusion and exclusion criteria for effective (non-pharmacological) falls prevention interventions in cognitively impaired community-dwelling people over 65 years of age. Data from the selected papers were extracted into data extraction tables and analyzed according to study characteristics, measures, results, and quality.

Results: The review identified 11 studies providing data from 1,928 participants. Interventions included exercise, health assessment and management of risk, multi-component and cognitive behavioral programs, and hip protectors as falls risk reduction strategies. Seven of the selected studies showed an intervention effect in decreasing falls risk; however, only two of these showed a significant improvement in physical performance measures specifically in a cognitively impaired group.

Conclusions: The diversity of interventions, study designs, populations, and quality of the studies, which met inclusion criteria, resulted in conflicting evidence and inconclusive results for falls prevention interventions in this highly complex population.

Keywords

accidental fallsprevention and controlcognition disorderscommunity setting
Type
Review Article
Information
International Psychogeriatrics , Volume 25 , Issue 2 , February 2013 , pp. 215 - 227
Copyright
Copyright © International Psychogeriatric Association 2012

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