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

Victoire Leroy (), Valérie Martinet, Oumashankar Nunkessore, Christel Dentel, Hélène Durand, David Mockler, François Puisieux, Bertrand Fougère and Yaohua Chen
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Victoire Leroy: Division of Geriatric Medicine, 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
Bertrand Fougère: Division of Geriatric Medicine, Tours University Hospital, 37000 Tours, France
Yaohua Chen: Department of Gerontology, Lille University Hospital, 59000 Lille, France

IJERPH, 2023, vol. 20, issue 3, 1-16

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.

Keywords: falls; mild cognitive impairment; gait disorders; cognitive impairment (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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