Efficacy of Physical Exercise in Preventing Falls in Older Adults With Cognitive Impairment: A Systematic Review and Meta-Analysis
Efficacy of Physical Exercise in Preventing Falls in Older Adults With Cognitive Impairment: A Systematic Review and Meta-Analysis
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DOI：
10.1016/j.jamda.2014.08.007
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发表时间：
2015-02-01
影响因子：
7.6
通讯作者：
Law, Andrew Chi Kin
中科院分区：
文献类型：
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作者：
Chan, Wai Chi;Yeung, Jerry Wing Fai;Law, Andrew Chi Kin
目的：许多研究报道了在认知健康的老年人中通过运动预防跌倒。这项研究旨在确定目前的证据是否支持体育锻炼在预防认知障碍老年人跌倒方面也有效。方法：两名独立审稿人检索MEDLINE；EMBASE;PsycINFO;护理与相关健康文献累积索引；Cochrane对照试验中心注册；Cochrane骨、关节和肌肉创伤组专业注册；ClinicalTrials.gov;和英国临床研究网络研究组合到2013年7月，没有语言限制。我们纳入了随机对照试验，这些试验检验了体育锻炼对患有认知障碍的老年人的疗效。纳入试验的方法学质量根据Cochrane预防跌倒试验综述制定的标准进行评价。主要结局指标为跌倒率比。我们进行了一项荟萃分析来估计合并比率，并总结了通过体育锻炼预防跌倒的试验结果。结果：纳入了7项随机对照试验，涉及781名参与者，其中4项仅检查了患有认知障碍的老年人。认知障碍患者的亚组数据来自另外3项针对一般老年人群的试验。荟萃分析显示，体育锻炼对预防认知障碍老年人跌倒有显著作用，合并估计比率为0.68（95%可信区间0.51-0.91）。结论：目前的分析表明，体育锻炼对预防老年人认知障碍的跌倒有积极的作用。需要进一步的研究来确定预防这一人群跌倒的最佳运动方式和频率。(C) 2015 AMDA -急性和长期护理医学学会。
Objective: Numerous studies have reported the prevention of falls through exercise among cognitively healthy older people. This study aimed to determine whether the current evidence supports that physical exercise is also efficacious in preventing falls in older adults with cognitive impairment.Methods: Two independent reviewers searched MEDLINE; EMBASE; PsycINFO; the Cumulative Index to Nursing & Allied Health Literature; the Cochrane Central Register of Controlled Trials; the Cochrane Bone, Joint, and Muscle Trauma Group Specialized Register; ClinicalTrials.gov; and the UK Clinical Research Network Study Portfolio up to July 2013 without language restriction. We included randomized controlled trials that examined the efficacy of physical exercise in older adults with cognitive impairment. The methodological qualities of the included trials were appraised according to the criteria developed for the Cochrane review of fall prevention trials. The primary outcome measure was the rate ratio of falls. A meta-analysis was performed to estimate the pooled rate ratio and summarize the results of the trials on fall prevention through physical exercise.Results: Seven randomized controlled trials involving 781 participants were included, 4 of which examined solely older people with cognitive impairment. Subgroup data on persons with cognitive impairment were obtained from the other 3 trials that targeted older populations in general. The meta-analysis showed that physical exercise had a significant effect in preventing falls in older adults with cognitive impairment, with a pooled estimate of rate ratio of 0.68 (95% confidence interval 0.51-0.91).Conclusions: The present analysis suggests that physical exercise has a positive effect on preventing falls in older adults with cognitive impairment. Further studies will be required to determine the modality and frequency of exercise that are optimal for the prevention of falls in this population. (C) 2015 AMDA - The Society for Post-Acute and Long-Term Care Medicine.