What enables older people to continue with their falls prevention exercises? A qualitative systematic review

ABSTRACTThe prevention of falls is currently high on the health policy agenda in the United Kingdom, which has led to the establishment of many falls-prevention services. If these are to be effective, however, the acceptability of services to older people needs to be considered. This paper reports a systematic review of studies of older people's perceptions of these interventions. The papers for review were identified by searching electronic databases, checking reference lists, and contacting experts. Two authors independently screened the studies and extracted data on the factors relating to participation in, or adherence to, falls-prevention strategies. Twenty-four studies were identified, of which 12 were qualitative. Only one study specifically examined interventions that promote participation in falls-prevention programmes; the others explored older people's attitudes and views. The factors that facilitated participation included social support, low intensity exercise, greater education, involvement in decision-making, and a perception of the programmes as relevant and life-enhancing. Barriers to participation included fatalism, denial and under-estimation of the risk of falling, poor self-efficacy, no previous history of exercise, fear of falling, poor health and functional ability, low health expectations and the stigma associated with programmes that targeted older people.

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Understanding the views of older people in adhering to community based group exercise interventions: a qualitative systematic review

Physiotherapy ◽

10.1016/j.physio.2015.03.591 ◽

2015 ◽

Vol 101 ◽

pp. e373-e374

Author(s):

C. Farrance ◽

F. Tsofliou ◽

C.J. Clark

Keyword(s):

Systematic Review ◽

Older People ◽

Group Exercise ◽

Community Based ◽

Exercise Interventions ◽

Qualitative Systematic Review

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Protocol for a systematic review and meta-analysis assessing the effectiveness of deprescribing in falls prevention in older people

BMJ Open ◽

10.1136/bmjopen-2020-047190 ◽

2021 ◽

Vol 11 (11) ◽

pp. e047190

Author(s):

Lotta J Seppala ◽

Nellie Kamkar ◽

Jesper Ryg ◽

Tahir Masud ◽

Joost Daams ◽

...

Keyword(s):

Systematic Review ◽

Older People ◽

Current Knowledge ◽

Meta Analysis ◽

Risk Of Bias ◽

Falls Prevention ◽

Sensitivity Analyses ◽

Forest Plot ◽

Controlled Trials ◽

Cochrane Central Register

IntroductionOne of the known risk factors for fall incidents is the use of specific medications, fall-risk-increasing drugs (FRIDs). However, to date, there is uncertainty related to the effectiveness of deprescribing as a single intervention in falls prevention. Thus, a comprehensive update of the literature focusing on all settings in which older people receive healthcare and all deprescribing interventions is warranted to enhance the current knowledge.Methods and analysisThis systematic review protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic search was performed in Cochrane Central Register of Controlled Trials, MEDLINE, Embase and PsycINFO (2 November 2020). We will also search in trial registers. We will include randomised controlled trials, in which any deprescribing intervention is compared with usual care and reports falls as an outcome. Both title and abstract screening and full-text screening will be done by two reviewers. The Cochrane Collaboration revised tool of Risk of Bias will be applied to perform risk of bias assessment. We will categorise the results separately for every setting. If a group of sufficiently comparable studies will be identified, we will perform a meta-analysis applying random effects model. We will investigate heterogeneity using a combination of visual inspection of the forest plot along with consideration of the χ2 test and the I2 statistic results. We have prespecified several subgroup and sensitivity analyses.Ethics and disseminationEthics approval is not applicable for this study since no original data will be collected. The results will be disseminated through peer-reviewed publication and conference presentations. Furthermore, this systematic review will inform the recommendations of working group of polypharmacy and FRIDs of the anticipated World’s Falls Guidelines.PROSPERO registration numberCRD42020218231.

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Falls prevention interventions for community-dwelling older people living in mainland China: a narrative systematic review

BMC Health Services Research ◽

10.1186/s12913-020-05645-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Pengpeng Ye ◽

Yishu Liu ◽

Jing Zhang ◽

Ke Peng ◽

Xuru Pan ◽

...

Keyword(s):

Systematic Review ◽

Older People ◽

Mainland China ◽

Community Dwelling ◽

Falls Prevention ◽

Prevention Interventions ◽

Community Dwelling Older People

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Falls prevention interventions for community-dwelling older persons with cognitive impairment: a systematic review

International Psychogeriatrics ◽

10.1017/s1041610212001573 ◽

2012 ◽

Vol 25 (2) ◽

pp. 215-227 ◽

Cited By ~ 34

Author(s):

Heidi Winter ◽

Kerrianne Watt ◽

Nancye May Peel

Keyword(s):

Systematic Review ◽

Cognitive Impairment ◽

Older People ◽

Large Body ◽

Community Dwelling ◽

Falls Prevention ◽

Original Research ◽

Cognitively Impaired ◽

Falls Risk ◽

Prevention Interventions

ABSTRACTBackground: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.

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