Table 1.
Demographics and Characteristics of Fall Prevention Intervention Included Studies
| Study, Year (ref) | Location | N1 | Age, mean y (SD) | Gender2 (F/M, %) | Tool (score/cut off), Baseline Score, & Level of CI | Study Design | Intervention Duration3 | Intervention Category & Setting | Control | Outcomes | Harms |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Varriano, 2020 [37] | Canada | 7 | O: 79.1 (6.7) | 57/43 |
MoCA (15–26) O: 21.2 (2.9) Mixed CI |
RCT | 12 weeks |
Exercise; vestibular exercises N/R |
Usual care | Balance, Gait speed and control | Falls, but unclear if due to intervention |
| Goldberg, 2019 [38] | United Kingdom | 60 | O: 76 (range 65–91) | 43/57 |
MMSE (18–26) O: 25.6 (3.1); I: 24.8 (3.6); 26.2 (3.2); C: 25.9 (2.4) Mild dementia or CI |
RCT | 12 months |
Exercise; Balance, strength, dual-task training, gait re-education Home-based |
Single falls prevention assessment | Falls, Perceived risk of falling, Balance, Gait speed and control, Functional mobility (TUG) | 19 recorded adverse events (5 non-serious but intervention related) |
| Padala, 2017 [39] | USA | 30 |
O: 73.0 (6.2); I: 72.1 (5.3); C: 73.9 (7.1) |
37/63 |
MMSE (≥18) O: 22.9 (2.2); I: 23.3 (2.2); C: 22.7 (2.3) Mild AD |
RCT | 8 weeks |
Exercise; Wii-fit (yoga, strength, aerobics, balance) Home-based |
Self-paced walking program | Perceive risk of falling, Balance | None study related |
| Zieschang, 2017 [40] | Germany | 122 |
I: 82.1 (6.6); C: 82.2 (6.7) |
74/262 |
MMSE (17–26) I: 21.6 (2.9); C: 21.9 (3.3) Mild to moderate dementia |
RCT | 3 months |
Exercise; progressive resistance and functional training (activities of daily living, balance, walking, gait) N/R |
Seated motor training exercises | Falls | N/R |
| Sungkarat, 2017 [41] | Thailand | 66 |
I: 68.3 (6.7); C: 67.5 (7.3) |
50/50 |
MoCA (< 26), MMSE (≥24) I: MoCA: 21.2 (3.4), MMSE: 26.5 (1.7); C: MoCA: 20.4 (3.8), MMSE: 25.8 (2.3) Mild CI |
RCT | 15 weeks |
Exercise; Tai Chi Community-centre and home-based |
Educational material covering information related to cognitive impairment and fall prevention |
Perceive risk of falling, Balance, Functional mobility (muscle strength data*) |
No adverse events found. |
| Schwenk, 2016 [42] | USA | 22 |
O: 78.2 (8.7); I: 77.8 (6.9); C: 79.0 (10.4) |
55/45 |
MoCA (> 20) O: 23.3 (2.6); I: 23.3 (3.1); C: 22.4 (3.0) Mild CI |
RCT | 4 weeks |
Exercise; Balance (ankle point-to-point reaching tasks and virtual obstacle-crossing tasks) Research centre |
Usual care |
Perceive risk of falling, Balance, Gait speed and control |
No training-related adverse events occurred. |
| Montero-Odasso, 2019 [47] | Canada | 60 |
O: 75.28 (7.18); I: 73.45 (5.74); C: 77.24 (8.11) |
45/55 |
CDR (0.5), MMSE, MoCA O: sMMSE: 27.47 (1.96), MoCA: 23.60 (2.52); I: sMMSE: 27.42 (2.19), MoCA: 23.19 (2.55); C: sMMSE: 27.52 (1.72), MoCA: 22.97 (2.37) Mild CI |
RCT | 6 months |
Medication or vitamin supplement; Donepezil Home-based |
Placebo |
Falls, Balance, Gait speed and control |
No major adverse events requiring treatment were reported. |
| Chen, 2018 [45] | Taiwan | 30 |
I: 77.3 (9.4); C: 77.3 (10.0) |
50/50 |
MMSE, CDR (0.5, 1 or 2) I: MMSE: 16.4 (7.3), CDR: 0.5 = 6, 1.0 = 6, 2.0 = 3; C: MMSE: 17.9 (3.7), CDR: 0.5 = 3, 1.0 = 9, 2.0 = 1 Mild to moderate dementia |
RCT | 2 months |
Multifactorial; Musical dual-task training (physical and cognitive tasks) Community/research centre |
Non-musical cognitive tasks and walking exercises | Perceive risk of falling, Gait speed and control, Functional mobility (TUG) | No adverse events reported. |
| Kim, 2017 [46] | Korea | 30 |
I: 82.0 (4.6); C: 80.9 (3.4) |
20/80 |
MMSE-Korea I: 15.5 (2.9); C: 15.6 (2.4) Mild to moderate dementia |
CCT | 12 weeks |
Multifactorial; physical activities, cognitive activities, activities of daily living, music activities Community centre |
Usual care | Perceive risk of falling, Balance, Functional mobility (TUG & CST) | N/R |
| Wesson, 2013 [17] | Australia | 22 |
I: 78.7 (4.2); C: 80.9 (5.0) |
41/59 |
ACE-R (≤82), MMSE I: ACE-R: 67.8 (12.6), MMSE: 24.5 (3.1); C: ACE-R: 62.5 (14.2), MMSE: 22.5 (4.3) Mild dementia |
RCT | 12 weeks |
Multifactorial; strength and balance exercises, home hazard reduction Home-based |
Usual care, health promotion brochures on fall prevention and home safety | Falls, Perceive risk of falling, Balance, Gait speed and control | No serious adverse events related to the intervention were reported. Minor complaints relating to stiffness, dizziness and mild joint pain (n = 4; 36%) were reported. |
| Suttanon, 2013 [43] | Australia | 40 |
O: 81.90 (5.72); I: 83.42 (5.10); C: 80.52 (6.01) |
63/37 |
MMSE (≥10) I: 20.89 (4.74); C: 21.67 (4.43) Mild to moderate AD |
RCT | 6 months |
Exercise; balance and strength exercises, walking program Home-based |
Education and information sessions on the topic of dementia and ageing | Falls, Perceive risk of falling, Balance, Gait speed and control, Functional mobility (TUG, CST, and FRT*) | There were no falls or other serious adverse events associated with the intervention |
| Hernandez, 2010 [44] | Brazil | 20 |
O: 78.5 (6.8); I: 77.7 (7.6); C: 84.0 (6.1) |
N/R |
CDR; MMSE I: 16.4 (6.7); C: 14.2 (5.1) Mild to moderate AD |
CCT | 6 months |
Exercise; stretching, weight training, circuits, dance, recreational activities, relaxation N/R |
Usual care | Balance, Functional mobility (TUG) | N/R |
CI cognitive impairment, O overall population, I intervention, C control, AD Alzheimer’s Disease, N/R not reported, RCT randomized controlled trial, CCT clinical (non-randomized) controlled trial. MoCA Montreal cognitive assessment (Score /30), MMSE Mini Mental State Exam, ACE-R Addenbrooke’s cognitive examination – revised, CDR Clinical Dementia Rating scale, TUG timed up and go test, CST chair sit stand test, FRT functional reach test. 1 Number of participants randomized to intervention; 2 Values for gender are based on reported baseline which may not equal N randomized but rather the number of participants who completed the intervention; 3 Not including follow-up, if applicable; *outcome not meta-analyzed