title: Falls prevention interventions for community-dwelling older persons with cognitive impairment: a systematic review.
abstract: BACKGROUND
  Globally, falls in older people are a leading cause of injury-related mortality and morbidity. Cognitive impairment is a well-known risk factor for falls in this population group. While there is now a large body of evidence to support effective interventions for falls reduction across care settings, very little is known about interventions in the vulnerable, but increasing population of cognitively impaired community-dwelling older people. Therefore, the purpose of this systematic review is to investigate interventions designed to reduce falls in community-dwelling, cognitively impaired older adults.
  
  
  METHODS
  A literature search of databases was conducted to identify original research published in English, which met predefined inclusion and exclusion criteria for effective (non-pharmacological) falls prevention interventions in cognitively impaired community-dwelling people over 65 years of age. Data from the selected papers were extracted into data extraction tables and analyzed according to study characteristics, measures, results, and quality.
  
  
  RESULTS
  The review identified 11 studies providing data from 1,928 participants. Interventions included exercise, health assessment and management of risk, multi-component and cognitive behavioral programs, and hip protectors as falls risk reduction strategies. Seven of the selected studies showed an intervention effect in decreasing falls risk; however, only two of these showed a significant improvement in physical performance measures specifically in a cognitively impaired group.
  
  
  CONCLUSIONS
  The diversity of interventions, study designs, populations, and quality of the studies, which met inclusion criteria, resulted in conflicting evidence and inconclusive results for falls prevention interventions in this highly complex population.
authors.affiliation: School of Population Health, The University of Queensland, Herston, Queensland 4006, Australia.
authors.forename: Heidi
authors.initials: H
authors.lastname: Winter
authors.forename: Kerrianne
authors.initials: K
authors.lastname: Watt
authors.forename: Nancye May
authors.initials: NM
authors.lastname: Peel
mesh_terms: D000056:Accident Prevention / Q000379:methods / Q000592:standards; D000058:Accidental Falls / Q000517:prevention & control / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000150:complications* / Q000175:diagnosis / Q000523:psychology; D015928:Cognitive Behavioral Therapy / Q000379:methods / Q000458:organization & administration; D004779:Environment Design; D015577:Geriatric Assessment / Q000379:methods; D040261:Harm Reduction; D006620:Hip Fractures / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D057187:Independent Living / Q000523:psychology / Q000592:standards / Q000706:statistics & numerical data; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic; D012306:Risk; D012946:Social Welfare / Q000706:statistics & numerical data*