The Effects of Combined Physical and Cognitive Interventions on Direct and Indirect Fall Outcomes for the Elderly with Mild Cognitive Impairment: A Systematic Review

Abstract

This review was intended to determine the effectiveness of physical and cognitive training (PCT) on falls and fall-related factors and cognitive function among community-dwelling elderly people with mild cognitive impairment (MCI). A systematic literature search was performed of the MEDLINE, CINAHL, Web of Sciences, Scopus, ProQuest, Embase, and Google Scholar databases for articles published from 2010 to 2020. The studies that combined PCT to assess their impacts on fall outcomes both directly and indirectly were included. Study quality was assessed using the standardized JBI Critical Appraisal Tool for RCTs. The standardized data extraction tool from JBI-MAStARI was used to extract data of included studies. Seven RCTs involving 740 participants were included. The overall fall incidence did not significantly decrease after the interventions. However, PCT significantly impacted the cognitive function and physical activities of elderly people with MCI, particularly improving their balancing ability, gait speed, muscular strength, and executive functions. This study indicated that combining PCT improves balance ability, gait speed, and executive functioning in the elderly with MCI, which may help to minimize fall occurrence.

Multimodal cognitive and behavioral interventions for patients with MCI: a systematic review and meta-analysis on cognition and mood

“…Thirdly, there is a lack of consensus on targeted outcomes. Some studies focused primarily on mobility ( Kiper et al, 2022 ; Mai Ba and Kim, 2022 ) while others focused on cognition ( Yan et al, 2022 ). Lastly, while one meta-analysis ( Meng et al, 2022 ) has synthesized clinical trials combining cognitive intervention and physical exercise on multiple cognitive domains in pwMCI, this meta-analysis excluded behavioral interventions other than physical exercise and included single intervention comparisons to study the additive effects instead of the overall impact of multimodal interventions.…”

Prevalence, risk factors and effectiveness of falls prevention interventions for adults living with Mild Cognitive Impairment in the community: A systematic review and meta-analysis

“…Only two systematic reviews were identified investigating Mild Cognitive Impairment and fall risk reduction for people living in the community. 16,17 Less than half of the studies included in these reviews actually measured falls events as an outcome measure.…”