Fall Prevention Interventions for Cognitively Impaired Older Adults: A Systematic Literature Review and Meta-Analysis

Area of Science:

• Gerontology
• Neurology
• Public Health

Background:

• Older adults with cognitive impairment face increased fall risks due to impaired judgment, balance, and mobility.
• The efficacy of fall prevention interventions in this demographic is not well-established.

Purpose of the Study:

• To evaluate the impact of fall prevention interventions on fall incidence in older adults experiencing cognitive impairment.
• This systematic review and meta-analysis aimed to synthesize current evidence.

Main Methods:

• A systematic review and meta-analysis adhering to PRISMA guidelines.
• Searched six databases for randomized or quasi-experimental trials (≥60 years with cognitive impairment) from Jan 2014-Dec 2023, with an updated search in May 2025.
• Included 17 studies (10 in meta-analysis) appraised for quality, synthesizing data using a random-effects model.

Main Results:

• Interventions encompassed exercise, technology, and environmental/cognitive strategies, delivered over 4-52 weeks.
• Meta-analysis revealed a significant reduction in fall rates for intervention groups (IRR=0.82, 95% CI: 0.69-0.98).
• Moderate heterogeneity was noted (I²=73.7%, p<.001).

Conclusions:

• Fall prevention interventions are effective in lowering fall rates among older adults with cognitive impairment.
• Implementing customized, evidence-based fall prevention strategies is vital for this vulnerable population.