Effect of Exercise and Cognitive Training on Falls and Fall-Related Factors in Older Adults With Mild Cognitive Impairment: A Systematic Review.
Author: Lipardo DS1, Aseron AMC2, Kwan MM3, Tsang WW4
Affiliation:
1Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China; College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines.
2College of Rehabilitation Sciences, University of Santo Tomas, Manila, Philippines.
3Rural Clinical School, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
4Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China. Electronic address: William.Tsang@polyu.edu.hk.
Conference/Journal: Arch Phys Med Rehabil.
Date published: 2017 Oct
Other:
Volume ID: 98 , Issue ID: 10 , Pages: 2079-2096 , Special Notes: doi: 10.1016/j.apmr.2017.04.021. Epub 2017 May 26. , Word Count: 278
OBJECTIVE: To evaluate the effect of exercise and cognitive training on falls reduction and on factors known to be associated with falls among community-dwelling older adults with mild cognitive impairment (MCI).
DATA SOURCES: Seven databases (PubMed, CINAHL, Cochrane Library, Web of Science, ProQuest, ProQuest Dissertations and Theses, Digital Dissertation Consortium) and reference lists of pertinent articles were searched.
STUDY SELECTION: Randomized controlled trials (RCTs) on the effect of exercise, cognitive training, or a combination of both on falls and factors associated with falls such as balance, lower limb muscle strength, gait, and cognitive function among community-dwelling older adults with MCI were included.
DATA EXTRACTION: Data were extracted using the modified Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) tool. Study quality was assessed using the JBI-MAStARI appraisal instrument.
DATA SYNTHESIS: Seventeen RCTs (1679 participants; mean age ± SD, 74.4±2.4y) were included. Exercise improved gait speed and global cognitive function in MCI; both are known factors associated with falls. Cognitive training alone had no significant effect on cognitive function, while combined exercise and cognitive training improved balance in MCI. Neither fall rate nor the number of fallers was reported in any of the studies included.
CONCLUSIONS: This review suggests that exercise, and combined exercise and cognitive training improve specific factors associated with falls such as gait speed, cognitive function, and balance in MCI. Further research on the direct effect of exercise and cognitive training on the fall rate and incidence in older adults with MCI with larger sample sizes is highly recommended.
Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
KEYWORDS: Cognitive dysfunction; Cognitive therapy; Exercise; Frail elderly; Rehabilitation
PMID: 28554873 DOI: 10.1016/j.apmr.2017.04.021
BACK
