TY - JOUR
T1 - Interventions to reduce the number of falls among older adults with/without cognitive impairment
T2 - An exploratory meta-analysis
AU - Guo, Jong Long
AU - Tsai, Yi Ying
AU - Liao, Jung Yu
AU - Tu, Hsiu Mei
AU - Huang, Chiu Mieh
PY - 2014/7
Y1 - 2014/7
N2 - 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.
AB - 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.
KW - accidental falls
KW - cognitive impairment
KW - elderly
KW - exercise intervention
KW - fall prevention
KW - meta-analysis
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U2 - 10.1002/gps.4056
DO - 10.1002/gps.4056
M3 - Review article
C2 - 24318959
AN - SCOPUS:84902254644
SN - 0885-6230
VL - 29
SP - 661
EP - 669
JO - International Journal of Geriatric Psychiatry
JF - International Journal of Geriatric Psychiatry
IS - 7
ER -
