Prevalence, risk factors and effectiveness of falls prevention interventions for adults living with Mild Cognitive Impairment in the community: A systematic review and meta-analysis

Objectives: To identify falls prevalence, falls risk factors and evaluate the effectiveness of falls prevention interventions for community-dwelling people with Mild Cognitive Impairment. Data sources: Peer-reviewed articles (inception to 4 August 2022) from PubMed, CINAHL, Psyclnfo, EMBASE, Scopus, SportDiscus and the Cochrane library. Review methods: All types of methodological approaches were considered. Inclusion criteria were community-dwelling; diagnosis of Mild Cognitive Impairment; aged 50+ years. Interventions needed to include falls prevention programs aiming to reduce falls and/or risk of falls. Outcomes of interest included number and/or rate of falls, falls prevalence and falls risk factors. For controlled trials, any control group was included. Quality assessment was completed using Cochrane's Risk of Bias Tool for randomized controlled trials and the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields for all other studies. Where statistical data pooling was not possible, narrative synthesis was used to present data in tables and figures. Results: Forty-seven studies were included. Prevalence of falls was 43% when data were gathered prospectively for 12 months. Confirmed falls risk factors included slow gait, dual-tasking, postural control and non-amnesic Mild Cognitive Impairment. Few studies evaluated interventions to reduce falls. Six meta-analyses were conducted, no significant reduction in falls was found. Conclusions: Until further high-quality, adequately powered studies are available to guide practice, best practice guidelines recommend balance training as a core component of falls prevention programs for older people generally, as well as people with Mild Cognitive Impairment.

Automated summary

This review study investigated the falls prevalence, falls risk factors, and the effectiveness of falls prevention interventions for community-dwelling individuals with Mild Cognitive Impairment. The findings revealed a high prevalence of falls, and identified several risk factors such as slow gait, dual-tasking, postural control, and non-amnesic Mild Cognitive Impairment. However, there were limited studies on falls prevention interventions, and no significant reduction in falls was observed. Best practice guidelines recommend balance training as a core component of falls prevention programs for older adults and people with Mild Cognitive Impairment.