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Table 1 Demographics and Characteristics of Fall Prevention Intervention Included Studies

From: Fall prevention in community-dwelling adults with mild to moderate cognitive impairment: a systematic review and meta-analysis

Study, Year (ref) Location N1 Age, mean y (SD) Gender2 (F/M, %) Tool (score/cut off), Baseline Score, & Level of CI Study Design Intervention Duration3 Intervention Category & Setting Control Outcomes Harms
Varriano, 2020 [37] Canada 7 O: 79.1 (6.7) 57/43 MoCA (15–26)
O: 21.2 (2.9)
Mixed CI
RCT 12 weeks Exercise; vestibular exercises
N/R
Usual care Balance, Gait speed and control Falls, but unclear if due to intervention
Goldberg, 2019 [38] United Kingdom 60 O: 76 (range 65–91) 43/57 MMSE (18–26)
O: 25.6 (3.1);
I: 24.8 (3.6); 26.2 (3.2);
C: 25.9 (2.4)
Mild dementia or CI
RCT 12 months Exercise; Balance, strength, dual-task training, gait re-education
Home-based
Single falls prevention assessment Falls, Perceived risk of falling, Balance, Gait speed and control, Functional mobility (TUG) 19 recorded adverse events (5 non-serious but intervention related)
Padala, 2017 [39] USA 30 O: 73.0 (6.2);
I: 72.1 (5.3);
C: 73.9 (7.1)
37/63 MMSE (≥18)
O: 22.9 (2.2);
I: 23.3 (2.2);
C: 22.7 (2.3)
Mild AD
RCT 8 weeks Exercise; Wii-fit (yoga, strength, aerobics, balance)
Home-based
Self-paced walking program Perceive risk of falling, Balance None study related
Zieschang, 2017 [40] Germany 122 I: 82.1 (6.6);
C: 82.2 (6.7)
74/262 MMSE (17–26)
I: 21.6 (2.9);
C: 21.9 (3.3)
Mild to moderate dementia
RCT 3 months Exercise; progressive resistance and functional training (activities of daily living, balance, walking, gait)
N/R
Seated motor training exercises Falls N/R
Sungkarat, 2017 [41] Thailand 66 I: 68.3 (6.7);
C: 67.5 (7.3)
50/50 MoCA (< 26), MMSE (≥24)
I: MoCA: 21.2 (3.4), MMSE: 26.5 (1.7);
C: MoCA: 20.4 (3.8), MMSE: 25.8 (2.3)
Mild CI
RCT 15 weeks Exercise; Tai Chi
Community-centre and home-based
Educational material covering information related to cognitive impairment and fall prevention Perceive risk of falling,
Balance,
Functional mobility (muscle strength data*)
No adverse events found.
Schwenk, 2016 [42] USA 22 O: 78.2 (8.7);
I: 77.8 (6.9);
C: 79.0 (10.4)
55/45 MoCA (> 20)
O: 23.3 (2.6);
I: 23.3 (3.1);
C: 22.4 (3.0)
Mild CI
RCT 4 weeks Exercise; Balance (ankle point-to-point reaching tasks and virtual obstacle-crossing tasks)
Research centre
Usual care Perceive risk of falling,
Balance,
Gait speed and control
No training-related adverse events occurred.
Montero-Odasso, 2019 [47] Canada 60 O: 75.28 (7.18);
I: 73.45 (5.74);
C: 77.24 (8.11)
45/55 CDR (0.5), MMSE, MoCA
O: sMMSE: 27.47 (1.96), MoCA: 23.60 (2.52);
I: sMMSE: 27.42 (2.19), MoCA: 23.19 (2.55);
C: sMMSE: 27.52 (1.72), MoCA: 22.97 (2.37)
Mild CI
RCT 6 months Medication or vitamin supplement; Donepezil
Home-based
Placebo Falls,
Balance,
Gait speed and control
No major adverse events requiring treatment were reported.
Chen, 2018 [45] Taiwan 30 I: 77.3 (9.4);
C: 77.3 (10.0)
50/50 MMSE, CDR (0.5, 1 or 2)
I: MMSE: 16.4 (7.3), CDR: 0.5 = 6, 1.0 = 6, 2.0 = 3;
C: MMSE: 17.9 (3.7), CDR: 0.5 = 3, 1.0 = 9, 2.0 = 1
Mild to moderate dementia
RCT 2 months Multifactorial; Musical dual-task training (physical and cognitive tasks)
Community/research centre
Non-musical cognitive tasks and walking exercises Perceive risk of falling, Gait speed and control, Functional mobility (TUG) No adverse events reported.
Kim, 2017 [46] Korea 30 I: 82.0 (4.6);
C: 80.9 (3.4)
20/80 MMSE-Korea
I: 15.5 (2.9);
C: 15.6 (2.4)
Mild to moderate dementia
CCT 12 weeks Multifactorial; physical activities, cognitive activities, activities of daily living, music activities
Community centre
Usual care Perceive risk of falling, Balance, Functional mobility (TUG & CST) N/R
Wesson, 2013 [17] Australia 22 I: 78.7 (4.2);
C: 80.9 (5.0)
41/59 ACE-R (≤82), MMSE
I: ACE-R: 67.8 (12.6), MMSE: 24.5 (3.1);
C: ACE-R: 62.5 (14.2), MMSE: 22.5 (4.3)
Mild dementia
RCT 12 weeks Multifactorial; strength and balance exercises, home hazard reduction
Home-based
Usual care, health promotion brochures on fall prevention and home safety Falls, Perceive risk of falling, Balance, Gait speed and control No serious adverse events related to the intervention were reported. Minor complaints relating to stiffness, dizziness and mild joint pain (n = 4; 36%) were reported.
Suttanon, 2013 [43] Australia 40 O: 81.90 (5.72);
I: 83.42 (5.10);
C: 80.52 (6.01)
63/37 MMSE (≥10)
I: 20.89 (4.74);
C: 21.67 (4.43)
Mild to moderate AD
RCT 6 months Exercise; balance and strength exercises, walking program
Home-based
Education and information sessions on the topic of dementia and ageing Falls, Perceive risk of falling, Balance, Gait speed and control, Functional mobility (TUG, CST, and FRT*) There were no falls or other serious adverse events associated with the intervention
Hernandez, 2010 [44] Brazil 20 O: 78.5 (6.8);
I: 77.7 (7.6);
C: 84.0 (6.1)
N/R CDR; MMSE
I: 16.4 (6.7);
C: 14.2 (5.1)
Mild to moderate AD
CCT 6 months Exercise; stretching, weight training, circuits, dance, recreational activities, relaxation
N/R
Usual care Balance, Functional mobility (TUG) N/R
  1. CI cognitive impairment, O overall population, I intervention, C control, AD Alzheimer’s Disease, N/R not reported, RCT randomized controlled trial, CCT clinical (non-randomized) controlled trial. MoCA Montreal cognitive assessment (Score /30), MMSE Mini Mental State Exam, ACE-R Addenbrooke’s cognitive examination – revised, CDR Clinical Dementia Rating scale, TUG timed up and go test, CST chair sit stand test, FRT functional reach test. 1 Number of participants randomized to intervention; 2 Values for gender are based on reported baseline which may not equal N randomized but rather the number of participants who completed the intervention; 3 Not including follow-up, if applicable; *outcome not meta-analyzed