The Ability of Physical Performance Measures to Identify Fall Risk in Older Adults Living With Dementia: A Systematic Review and Meta-Analysis

Wayne LS Chan (Corresponding Author), Wai Mun Pin, Jason Y.H. Chan, George C.H. Siu, Man Ha Tsang

Research output: Journal article publicationReview articleAcademic researchpeer-review

Abstract

Objectives
To determine whether physical performance measures commonly used in clinical settings can discriminate fallers from nonfallers and predict falls in older adults with dementia.

Design
Systematic review and meta-analysis.

Setting and Participants
Older adults with dementia residing in the community, hospitals, and residential care facilities.

Methods
MEDLINE, Embase, PsycINFO, CINAHL, SPORTDiscus, the Cochrane Library, and the PEDro databases were searched from inception until December 27, 2023 (PROSPERO registration number: CRD42022303670). Retrospective or prospective studies that evaluated the associations between physical performance measures and falls in older adults with dementia were included. A random effects model was used to calculate the standardized mean difference (SMD) and 95% CI for each physical performance measure between fallers and nonfallers. Sensitivity analyses were conducted on the longitudinal studies to determine the ability of physical performance measures to predict future falls.

Results
Twenty-eight studies were included in this review (n = 3542). The 5-time chair stand test [SMD = 0.23 (0.01, 0.45)], the Berg Balance Scale [SMD = −0.52 (–0.87, −0.17)], postural sway when standing on the floor [SMD = 0.25 (0.07, 0.43)] and on a foam surface [SMD = 0.45 (0.25, 0.66)], and the Short Physical Performance Battery total score [SMD = −0.46 (–0.66, −0.27)] could discriminate fallers from nonfallers. Sensitivity analyses showed that gait speed could predict future falls in longitudinal cohort studies [SMD = −0.29 (–0.49, −0.08)]. Subgroup analyses showed that gait speed [SMD = −0.21 (–0.38, −0.05)] and the Timed Up and Go test [SMD = 0.54 (0.16, 0.92)] could identify fallers staying in residential care facilities or hospitals.

Conclusions and Implications
The 5-time chair stand test, the Berg Balance Scale, postural sway when standing on the floor and a foam surface, and the Short Physical Performance Battery can be used to predict falls in older adults with dementia. Gait speed and the Timed Up and Go test can be used to predict falls in institutionalized older adults with dementia. Clinicians are recommended to use these physical performance measures to assess fall risk in older adults with dementia.
Original languageEnglish
Article number105100
JournalJournal of the American Medical Directors Association
Volume25
Issue number8
DOIs
Publication statusPublished - 19 Jun 2024

Keywords

  • Falls
  • dementia
  • discriminative ability
  • outcome measures
  • physical performance

ASJC Scopus subject areas

  • General Nursing
  • Health Policy
  • Geriatrics and Gerontology

Fingerprint

Dive into the research topics of 'The Ability of Physical Performance Measures to Identify Fall Risk in Older Adults Living With Dementia: A Systematic Review and Meta-Analysis'. Together they form a unique fingerprint.

Cite this