Cognitive functioning and falls in older people: A systematic review and meta-analysis

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics Pub Date : 2024-09-15 DOI:10.1016/j.archger.2024.105638

Daina L STURNIEKS , Lloyd LY CHAN , Maria Teresa ESPINOZA CERDA , Carmen HERRERA ARBONA , Beatriz HERRERO PINILLA , Paula SANTIAGO MARTINEZ , Nigel Wei SENG , Natassia SMITH , Jasmine C MENANT , Stephen R LORD

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引用次数: 0

Abstract

Objective

To identify which cognitive functions and specific neuropsychological assessments predict falls in older people living in the community.

Methods

Five electronic databases were searched until 30/08/2022 for studies assessing the association between specific cognitive functions and faller status (prospective and retrospective), in community-dwelling older people. Risk of bias was assessed with the Newcastle-Ottawa Scale. Meta-analyses synthesised the evidence regarding the associations between different neurocognitive subdomains and faller status.

Results

Thirty-eight studies (20 retrospective, 18 prospective) involving 37,101 participants were included. All but one study was rated high or medium quality. Meta-analyses were performed with data from 28 studies across 11 neurocognitive subdomains and four specific neuropsychological tests. Poor cognitive flexibility, processing speed, free recall, working memory and sustained attention were significantly associated with faller status, but poor verbal fluency, visual perception, recognition memory, visuo-constructional reasoning and language were not. The Trail Making Test B was found to have the strongest association with faller status.

Conclusion

Poor performance in neurocognitive subdomains spanning processing speed, attention, executive function and aspects of memory are associated with falls in older people, albeit with small effect sizes. The Trail Making Test, a free-to-use, simple assessment of processing speed and mental flexibility, is recommended as the cognitive screening test for fall risk in older people.

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认知功能与老年人跌倒：系统回顾与荟萃分析

方法在 2022 年 8 月 30 日前的五个电子数据库中检索了评估社区老年人特定认知功能与跌倒状况之间关系的研究（前瞻性和回顾性）。偏倚风险采用纽卡斯尔-渥太华量表进行评估。结果共纳入 38 项研究（20 项回顾性研究和 18 项前瞻性研究），涉及 37101 名参与者。除一项研究外，其他研究均被评为高质量或中等质量。对 28 项研究的数据进行了元分析，涉及 11 个神经认知子域和 4 个特定的神经心理学测试。认知灵活性、处理速度、自由回忆、工作记忆和持续注意力较差与跌倒者身份有显著相关性，但言语流畅性、视觉感知、识别记忆、视觉结构推理和语言能力较差与跌倒者身份无显著相关性。结论在神经认知子域（包括处理速度、注意力、执行功能和记忆的各个方面）的不良表现与老年人跌倒有关，尽管影响程度很小。建议将 "走小路测试 "作为老年人跌倒风险的认知筛查测试，该测试可免费使用，是对处理速度和心理灵活性的简单评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of gerontology and geriatrics 医学-老年医学

CiteScore

7.30

自引率

5.00%

发文量

198

审稿时长

16 days

期刊介绍： Archives of Gerontology and Geriatrics provides a medium for the publication of papers from the fields of experimental gerontology and clinical and social geriatrics. The principal aim of the journal is to facilitate the exchange of information between specialists in these three fields of gerontological research. Experimental papers dealing with the basic mechanisms of aging at molecular, cellular, tissue or organ levels will be published. Clinical papers will be accepted if they provide sufficiently new information or are of fundamental importance for the knowledge of human aging. Purely descriptive clinical papers will be accepted only if the results permit further interpretation. Papers dealing with anti-aging pharmacological preparations in humans are welcome. Papers on the social aspects of geriatrics will be accepted if they are of general interest regarding the epidemiology of aging and the efficiency and working methods of the social organizations for the health care of the elderly.