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Leroy V, Martinet V, Nunkessore O, Dentel C, Durand H, Mockler D, Puisieux F, Fougère B, Chen Y. The Nebulous Association between Cognitive Impairment and Falls in Older Adults: A Systematic Review of the Literature. Int J Environ Res Public Health 2023; 20:2628. [PMID: 36767992 PMCID: PMC9915123 DOI: 10.3390/ijerph20032628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND In older people, dementia is a well-established risk factor for falls. However, the association and the causal relationship between falls and the earlier stages of cognitive impairment remains unclear. The purpose of the study was to review the literature data on the association between falls and cognitive impairment, no dementia, including Mild Cognitive Impairment. METHODS According to PRISMA guidelines, we searched five electronic databases (EMBASE, Web of Science, Medline, CINAHL, and PsychINFO) for articles published between January 2011 and August 2022 on observational studies of older people with a cognitive assessment and/or cognitive impairment diagnosis and a recording of falls. Their quality was reviewed according to the STROBE checklist. RESULTS We selected 42 of the 4934 initially retrieved publications. In 24 retrospective studies, a statistically significant association between falls and cognitive status was found in only 15 of the 32 comparisons (47%). Of the 27 cross-sectional analyses in prospective studies, only eight (30%) were positive and significant. We counted four longitudinal analyses, half of which suggested a causal relationship between falls and cognitive impairment. The investigational methods varied markedly from one study to another. CONCLUSION It is still not clear whether falls are associated with cognitive impairment, no dementia. Data in favor of a causal relationship are scarce. Further studies are needed to clarify their relationship.
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Affiliation(s)
- Victoire Leroy
- Division of Geriatric Medicine, Tours University Hospital, 37000 Tours, France
- EA 7505 (Education, Ethics, Health), University of Medicine of Tours, 37000 Tours, France
- Memory Clinic, Tours University Hospital, 37000 Tours, France
| | - Valérie Martinet
- Department of Geriatrics, Saint-Pierre Hospital, ULB, 1000 Brussels, Belgium
| | | | | | - Hélène Durand
- Department of Neurology, Hautepierre Hospital, Strasbourg University Hospital, 67200 Strasbourg, France
| | - David Mockler
- Medical Library, Trinity Centre for the Health Sciences, St James’ Hospital, D08 W9RT Dublin, Ireland
| | - François Puisieux
- Department of Gerontology, Lille University Hospital, 59000 Lille, France
- EA2694, Lille University, 59000 Lille, France
| | - Bertrand Fougère
- Division of Geriatric Medicine, Tours University Hospital, 37000 Tours, France
- EA 7505 (Education, Ethics, Health), University of Medicine of Tours, 37000 Tours, France
| | - Yaohua Chen
- Department of Gerontology, Lille University Hospital, 59000 Lille, France
- INSERM UMR-S 1172, Vascular and Degenerative Cognitive Disorders, University of Lille, 59000 Lille, France
- Global Brain Health Institute, Trinity College Dublin, D02 PN40 Dublin, Ireland
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