Falls prevention interventions in older adults with cognitive impairment: A systematic review of reviews

Booth, Victoria; Logan, Pip; Harwood, Rowan H.; Hood, Victoria

doi:10.12968/ijtr.2015.22.6.289

Cited by 41 publications

(46 citation statements)

References 30 publications

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“…Currently, evidence for effective interventions to reduce the risk of falls, to reduce polypharmacy and to improve nutrition is limited and requires further development (56)(57)(58)(59)(60). Nevertheless, the results of the present study suggest that the identification and management of these three geriatric syndromes might help preventing hospitalisation events among people with dementia.…”

Section: Discussionmentioning

confidence: 81%

Hospital transfer of people with dementia: results of the European RightTimePlaceCare project on their frequency, factors associated and costs

Afonso-Argilés¹,

Meyer²,

Stephan³

et al. 2020

Preprint

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Background Hospitalisation is a critical moment for people with dementia and a major challenge for health care systems. The aims of this study were 1) to describe the frequency of hospital transfer among people with dementia from eight European countries, 2) to examine the factors associated with hospital transfer and 3) to evaluate the costs related with it. Methods The present study is a secondary data analysis of the RightTimePlaceCare European project. A cross-sectional survey was carried out with data collected from people with dementia who lived either at home or had been admitted to a nursing home in the last three months, as well as from their caregivers. Data on hospital transfers at three months were gathered with the "The Resource Utilization in Dementia" instrument. Demographic data, functional, cognitive and neuropsychiatric symptoms, comorbidity, polypharmacy, caregiver burden, nutritional status and falls were evaluated with validated tools. Multivariate regression models were used to investigate the factors associated with hospital transfers. Costs were estimated by multiplying quantities of resources used with the unit cost of each resource and inflated to the year 2018. Results The study sample comprised 1,700 people with dementia and their informal caregivers. Within three months, 16.7% experienced ≥ 1 hospital transfers. Multivariate logistic regression model showed a higher probability of hospital transfers among people with dementia with unintentional weight loss, polypharmacy, falls and those living in the community. The estimated costs per person with dementia/year among the participants living in a nursing home were 980.56 euros and 2,535.39 euros among those receiving home care. Conclusion Transfer to hospital is frequent among people with dementia, especially among those living in the community. These events are associated with the onset of geriatric syndromes such as involuntary weight loss, accidental falls and polypharmacy, and impose a remarkable economic burden. These results suggest that there is a need to develop and implement cost-effective supportive interventions that focus on the identification of people with dementia at risk of hospital transfer, the assessment and management of these geriatric syndromes and the promotion of individualised care planning for them, in order to prevent unnecessary hospital transfers.

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Section: Discussionmentioning

confidence: 81%

Hospital transfer of people with dementia: results of the European RightTimePlaceCare project on their frequency, factors associated and costs

Afonso-Argilés¹,

Meyer²,

Stephan³

et al. 2020

Preprint

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“…The CMO configurations (CMOcs) were progressively refined to determine multiple rough programme theories within only one stage of the patient journey, the strength and balance exercises. This was an iterative process based on prior knowledge of the literature in fall prevention [ 25 ] and previous clinical experience. Mental models [ 26 ] were mapped according to potential CMOs and collated together into CMOcs.…”

Section: Methodsmentioning

confidence: 99%

Understanding the theoretical underpinning of the exercise component in a fall prevention programme for older adults with mild dementia: a realist review protocol

et al. 2016

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BackgroundOlder adults with mild dementia are at an increased risk of falls. Preventing those at risk from falling requires complex interventions involving patient-tailored strength- and balance-challenging exercises, home hazard assessment, visual impairment correction, medical assessment and multifactorial combinations. Evidence for these interventions in older adults with mild cognitive problems is sparse and not as conclusive as the evidence for the general community-dwelling older population. The objectives of this realist review are (i) to identify the underlying programme theory of strength and balance exercise interventions targeted at those individuals that have been identified as falling and who have a mild dementia and (ii) to explore how and why that intervention reduces falls in that population, particularly in the context of a community setting. This protocol will explain the rationale for using a realist review approach and outline the method.MethodsA realist review is a methodology that extends the scope of a traditional narrative or systematic evidence review. Increasingly used in the evaluation of complex interventions, a realist enquiry can look at the wider context of the intervention, seeking more to explain than judge if the intervention is effective by investigating why, what the underlying mechanism is and the necessary conditions for success. In this review, key rough programme theories were articulated and defined through discussion with a stakeholder group. The six rough programme theories outlined within this protocol will be tested against the literature found using the described comprehensive search strategy. The process of data extraction, appraisal and synthesis is outlined and will lead to the production of an explanatory programme theory.DiscussionAs far as the authors are aware, this is the first realist literature review within fall prevention research and adds to the growing use of this methodology within healthcare. This synthesis of evidence will provide a valuable addition to the evidence base surrounding the exercise component of a fall intervention programme for older adults with mild dementia and will ultimately provide clinically relevant recommendations for improving the care of people with dementia.Systematic review registrationPROSPERO CRD42015030169Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0212-x) contains supplementary material, which is available to authorized users.

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“…The promotion of exercise to improve strength, balance, and coordination is also essential (Stubbs, Brefka, & Denkinger, ). The latter is a widely reported intervention in the literature (Booth, Logan, Harwood, & Hood, ). According to Keller et al.…”

Section: Public Health Nursing Interventionsmentioning

confidence: 99%

“…(Stubbs, Brefka, & Denkinger, 2015). The latter is a widely reported intervention in the literature (Booth, Logan, Harwood, & Hood, 2015). According to Keller et al (2004b) (Lauvrak & Norderhaug, 2010;Nikolaus & Bach, 2003).…”

Section: Pub LI C He Alth N Ur S Ing Interventi On Smentioning

confidence: 99%

A falls case summary: Application of the public health nursing intervention wheel

Leahy‐Warren

Day

Philpott

et al. 2018

Public Health Nursing

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Falls prevention interventions in older adults with cognitive impairment: A systematic review of reviews

Cited by 41 publications

References 30 publications

Hospital transfer of people with dementia: results of the European RightTimePlaceCare project on their frequency, factors associated and costs

Hospital transfer of people with dementia: results of the European RightTimePlaceCare project on their frequency, factors associated and costs

Understanding the theoretical underpinning of the exercise component in a fall prevention programme for older adults with mild dementia: a realist review protocol

A falls case summary: Application of the public health nursing intervention wheel

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