Interventions to reduce the number of falls among older adults with/without cognitive impairment: An exploratory meta-analysis

Jong Long Guo, Yi Ying Tsai, Jung Yu Liao, Hsiu Mei Tu, Chiu Mieh Huang

Research output: Contribution to journalReview article

33 Citations (Scopus)

Abstract

ObjectiveThis 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. DesignA 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. ResultsExercise 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. ConclusionsSingle 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.

Original languageEnglish
Pages (from-to)661-669
Number of pages9
JournalInternational Journal of Geriatric Psychiatry
Volume29
Issue number7
DOIs
Publication statusPublished - 2014 Jul

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Meta-Analysis
Confidence Intervals
House Calls
Vitamin D
Calcium
Cognitive Dysfunction
Cognition
Databases

Keywords

  • accidental falls
  • cognitive impairment
  • elderly
  • exercise intervention
  • fall prevention
  • meta-analysis

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Interventions to reduce the number of falls among older adults with/without cognitive impairment : An exploratory meta-analysis. / Guo, Jong Long; Tsai, Yi Ying; Liao, Jung Yu; Tu, Hsiu Mei; Huang, Chiu Mieh.

In: International Journal of Geriatric Psychiatry, Vol. 29, No. 7, 07.2014, p. 661-669.

Research output: Contribution to journalReview article

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abstract = "ObjectiveThis 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. DesignA 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. ResultsExercise 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. ConclusionsSingle 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.",
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