Interventions to reduce the number of falls among older adults with/without cognitive impairment: an exploratory meta-analysis
Version of Record online: 7 DEC 2013
Copyright © 2013 John Wiley & Sons, Ltd.
International Journal of Geriatric Psychiatry
Volume 29, Issue 7, pages 661–669, July 2014
How to Cite
Guo, J.-L., Tsai, Y.-Y., Liao, J.-Y., Tu, H.-M. and Huang, C.-M. (2014), Interventions to reduce the number of falls among older adults with/without cognitive impairment: an exploratory meta-analysis. Int. J. Geriat. Psychiatry, 29: 661–669. doi: 10.1002/gps.4056
- Issue online: 6 JUN 2014
- Version of Record online: 7 DEC 2013
- Manuscript Accepted: 29 OCT 2013
- Manuscript Received: 28 JAN 2013
- accidental falls;
- cognitive impairment;
- exercise intervention;
- fall prevention;
This exploratory meta-analysis aimed to examine and compare the effective interventions to prevent falls among institutionalized/non-institutionalized older adults without cognitive impairment with interventions to prevent falls for older adults with cognitive impairment.
A database search identified 111 trials published between January 1992 and August 2012 that evaluated fall-prevention interventions among institutionalized/non-institutionalized older adults with and without cognitive impairment as measured by valid cognition scales.
Exercise alone intervention was similar effective on reducing the numbers of falls among older adults without cognitive impairment regardless of setting (non-institutionalized: OR = 0.783, 95% confidence interval (CI) = 0.656–0.936; p = 0.007 institutionalized: OR = 0.799, 95% CI = 0.646–0.988, p = 0.038). Vitamin D/calcium supplementation had a positive effect on the reduction of numbers of falls among non-institutionalized older adults without cognitive impairment (OR = 0.789, 95% CI = 0.631–0.985, p = 0.036), as did home visits and environment modification (OR = 0.751, 95% CI = 0.565–0.998, p = 0.048). Exercise alone, exercise-related multiple interventions, and multifactorial interventions were associated with positive outcomes among both institutionalized and non-institutionalized older adults with cognitive impairment, but studies are limited.
Single exercise interventions can significantly reduce numbers of falls among older adults with and without cognitive impairment in institutional or non-institutional settings. Vitamin D and calcium supplementation, home visits, and environment modification can reduce the risk of falls among older adults in non-institutional settings. Exercise-related multiple interventions and multifactorial interventions may only be effective for preventing falls in older adults with cognitive impairment. Copyright © 2013 John Wiley & Sons, Ltd.