Fall Prevention in Adults With Cognitive Impairment: a Systematic Review and Meta Analysis

Falls affect individuals of all ages, including adults over 50 years. In fact, more than 30 per cent of the adult population aged 65 years and older experience falls. Among the factors which increase the risk of falls is cognitive impairment. For example, older adults with dementia fall two to three times more than cognitively healthy older adults, and 60-80 per cent of people with dementia fall within a year. Fall prevention interventions are complex and there has been limited literature which summarizes the best strategies and interventions to prevent or mitigate falls in community-dwelling adults with cognitive impairment. Further, current evidence-based guidelines for fall prevention have focused on strategies within institutional health care settings. Little is known about the applicability of these guidelines to adults living in the community or to adults with cognitive impairment. It has become clear from stakeholders such as clinicians and practitioners, that there is a need to better translate research into practice for this unique population.

To address these gaps in research and practice, the Aging, Community and Health Research Unit has partnered with the McMaster Evidence Review Synthesis Team (MERST) to conduct a systematic review and meta-analysis with the following two objectives:

1) Synthesize literature reporting the effectiveness of primary and secondary fall prevention interventions in community-living adults (50+ years) with mild to moderate cognitive impairment.

2) Summarize the strategies that support the successful implementation and scale-up of fall prevention programs.

Our methods will include: a) a systematic search of the literature based on defined search terms and inclusion/exclusion criteria; b) data extraction using validated tools; and c) data analysis including grading of studies to judge the certainty of evidence.

To ensure this research is applicable and actionable in practice, we will engage stakeholder groups throughout the duration of the project. Opportunities to engage stakeholders include, but are not limited to, establishing and voting upon outcomes for data extraction, verifying results of research and sharing of resources/citations for inclusion, checking guidelines and recommendations for applicability and feasibility, and dissemination and sharing of project results and guidelines. The project duration is one year, from March 2020 to March 2021.

Click here to read about this study on the Ontario Neurotrauma Foundation website

Publication in BMC Geriatrics