The role of cognitive impairment in fall risk among older adults: a systematic review and meta-analysis.
Background: cognitive impairment is an established fall risk factor; however, it is unclear whether a disease-specific diagnosis (i.e. dementia), measures of global cognition or impairments in specific cognitive domains (i.e. executive function) have the greatest association with fall risk. Our obje...
| Publicado en: | Age & Ageing Vol. 41; no. 3; pp. 299 - 309 |
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| Autores principales: | , , |
| Formato: | Artículo |
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Oxford University Press / USA
May2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=74580733&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 74580733 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: May2012 vid: 41 iid: 3 pid: 622 pub: Oxford University Press / USA artinfo: ui: 74580733 10.1093/ageing/afs012 ppf: 299 ppct: 10 formats: tig: atl: The role of cognitive impairment in fall risk among older adults: a systematic review and meta-analysis. aug: au: Muir, Susan W. Gopaul, Karen Montero Odasso, Manuel M. affil: Division of Geriatric Medicine, The University of Western Ontario , 801 Commissioners Road East, London, Ontario , Canada N6C 5J1 Gait and Brain Laboratory , Parkwood Hospital , London, Ontario , Canada Department of Epidemiology and Biostatistics , The University of Western Ontario , London, Ontario , Canada Lawson Health Research Institute , London, Ontario , Canada su: Epidemiology Old age Risk factors of falling down Cognition disorders Dementia Medical information storage & retrieval systems Psychology information storage & retrieval systems MEDLINE Meta-analysis Online information services Risk assessment Systematic reviews Data analysis sug: subj: Epidemiology Old age Risk factors of falling down Cognition disorders Dementia Medical information storage & retrieval systems Psychology information storage & retrieval systems MEDLINE Meta-analysis Online information services Risk assessment Systematic reviews Data analysis keyword: accidental falls cognition elderly meta-analysis risk factors systematic review accidental falls cognition elderly meta-analysis risk factors systematic review ab: Background: cognitive impairment is an established fall risk factor; however, it is unclear whether a disease-specific diagnosis (i.e. dementia), measures of global cognition or impairments in specific cognitive domains (i.e. executive function) have the greatest association with fall risk. Our objective was to evaluate the epidemiological evidence linking cognitive impairment and fall risk.Methods: studies were identified through systematic searches of the electronic databases of MEDLINE, EMBASE, PyschINFO (1988–2009). Bibliographies of retrieved articles were also searched. A fixed-effects meta-analysis was performed using an inverse-variance method.Results: twenty-seven studies met the inclusion criteria. Impairment on global measures of cognition was associated with any fall, serious injuries (summary estimate of OR = 2.13 (1.56, 2.90)) and distal radius fractures in community-dwelling older adults. Executive function impairment, even subtle deficits in healthy community-dwelling older adults, was associated with an increased risk for any fall (summary estimate of OR = 1.44 (1.20, 1.73)) and falls with serious injury. A diagnosis of dementia, without specification of dementia subtype or disease severity, was associated with risk for any fall but not serious fall injury in institution-dwelling older adults.Conclusion: the method used to define cognitive impairment and the type of fall outcome are both important when quantifying risk. There is strong evidence global measures of cognition are associated with serious fall-related injury, though there is no consensus on threshold values. Executive function was also associated with increased risk, which supports its inclusion in fall risk assessment especially when global measures are within normal limits. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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