Interventions to reduce the number of falls among older adults with/without cognitive impairment: an exploratory meta‐analysis. (7th December 2013)

• Record Type: Journal Article
• Authors: Guo, Jong‐Long; Tsai, Yi‐Ying; Liao, Jung‐Yu; Tu, Hsiu‐Mei; Huang, Chiu‐Mieh
• Is Part Of: International journal of geriatric psychiatry. Volume 29:Number 7(2014:Jul.)
• Page Start: 661
• Page End: 669
• Publication Date: 2013-12-07
• Subjects: Geriatric psychiatry -- Periodicals; Geriatric Psychiatry -- Periodicals; 618.97689
• DOI: 10.1002/gps.4056
• Languages: English
• ISSNs: 0885-6230

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="gps4056-sec-0001" sec-type="section"> <title>Objective</title> <p>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 <italic>with</italic> cognitive impairment.</p> </sec> <sec id="gps4056-sec-0002" sec-type="section"> <title>Design</title> <p>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.</p> </sec> <sec id="gps4056-sec-0003" sec-type="section"> <title>Results</title> <p>Exercise alone intervention was similar effective on reducing the numbers of falls among older adults without cognitive impairment regardless of setting (non‐institutionalized: <italic>OR</italic> = 0.783, 95% confidence interval (<italic>CI</italic>) = 0.656–0.936; <italic>p</italic> = 0.007 institutionalized: <italic>OR</italic> = 0.799, 95% <italic>CI</italic> = 0.646–0.988, <italic>p</italic> = 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 (<italic>OR</italic> = 0.789, 95% <italic>CI</italic> = 0.631–0.985, <italic>p</italic> = 0.036), as did home visits and environment modification (<italic>OR</italic> = 0.751, 95% <italic>CI</italic> = 0.565–0.998, <italic>p</italic> = 0.048). Exercise alone, exercise‐related multiple interventions, and multifactorial interventions were associated with positive outcomes among both institutionalized and non‐institutionalized older adults <italic>with</italic> cognitive impairment, but studies are limited.</p> </sec> <sec id="gps4056-sec-0004" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>