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The Nebulous Association between Cognitive Impairment and Falls in Older Adults: A Systematic Review of the Literature

Author

Listed:
  • 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)

  • Oumashankar Nunkessore

    (Department of Geriatrics, Dunkerque Hospital, 59240 Dunkerque, France)

  • Christel Dentel

    (Neurology Practice, 67170 Brumath, France)

  • 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)

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.

Suggested Citation

  • Victoire Leroy & Valérie Martinet & Oumashankar Nunkessore & Christel Dentel & Hélène Durand & David Mockler & François Puisieux & Bertrand Fougère & Yaohua Chen, 2023. "The Nebulous Association between Cognitive Impairment and Falls in Older Adults: A Systematic Review of the Literature," IJERPH, MDPI, vol. 20(3), pages 1-16, February.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:3:p:2628-:d:1053937
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    References listed on IDEAS

    as
    1. Maria dos Anjos Dixe & Carla Madeira & Silvia Alves & Maria Adriana Henriques & Cristina Lavareda Baixinho, 2021. "Gait Ability and Muscle Strength in Institutionalized Older Persons with and without Cognitive Decline and Association with Falls," IJERPH, MDPI, vol. 18(21), pages 1-11, November.
    2. Claire E. Adam & Annette L. Fitzpatrick & Cindy S. Leary & Anjum Hajat & Elizabeth A. Phelan & Christina Park & Erin O. Semmens, 2021. "The Association between Gait Speed and Falls in Community Dwelling Older Adults with and without Mild Cognitive Impairment," IJERPH, MDPI, vol. 18(7), pages 1-10, April.
    3. Lourdes Bujalance Díaz & María Jesús Casuso-Holgado & María Teresa Labajos-Manzanares & Francisco Javier Barón-López & Elena Pinero-Pinto & Rita Pilar Romero-Galisteo & Noelia Moreno-Morales, 2020. "Analysis of Fall Risk Factors in an Aging Population Living in Long-Term Care Institutions in SPAIN: A Retrospective Cohort Study," IJERPH, MDPI, vol. 17(19), pages 1-10, October.
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