Cognitive functioning and falls in older people: A systematic review and meta-analysis

Area of Science:

• Gerontology
• Neuropsychology
• Public Health

Background:

• Falls are a significant public health concern for older adults, leading to injury and reduced independence.
• Cognitive impairment is increasingly recognized as a contributing factor to falls in the elderly population.
• Identifying specific cognitive predictors of falls is crucial for developing targeted prevention strategies.

Purpose of the Study:

• To determine which cognitive functions and neuropsychological tests best predict falls in community-dwelling older individuals.
• To synthesize existing evidence on the association between cognitive performance and fall risk.

Main Methods:

• A systematic review and meta-analysis of studies published up to August 2022.
• Searched five electronic databases for relevant research on cognitive function and faller status.
• Included 38 studies (37,101 participants), assessing risk of bias and synthesizing data from 28 studies across 11 neurocognitive subdomains.

Main Results:

• Poor performance in cognitive flexibility, processing speed, free recall, working memory, and sustained attention was significantly associated with faller status.
• Verbal fluency, visual perception, recognition memory, visuo-constructional reasoning, and language were not significantly associated with falls.
• The Trail Making Test B demonstrated the strongest association with faller status.

Conclusions:

• Deficits in processing speed, attention, executive function, and memory are linked to increased fall risk in older adults, though effect sizes are small.
• The Trail Making Test, assessing processing speed and mental flexibility, is recommended for cognitive screening to evaluate fall risk in older populations.
• This highlights the importance of cognitive screening in fall prevention programs for the elderly.