The association of cognitive frailty and the risk of falls among older adults: A systematic review and meta-analysis

Background: Falls lead to numerous negative health outcomes and jeopardize the physical function and quality of life in older adults. Cognitive impairment and physical frailty were found to be associated with the risk of falls, but there was no systematic review that estimated the association between cognitive frailty and the risk of falls. Methods: A systematic literature search of the cross-sectional, cohort, and case–control studies in Cochrane library, Scopus, CINAHL, EMBASE and PsycINFO was conducted on 3 September 2021. Study quality was assessed by using the Joanna Briggs Institute critical appraisal tool. A random effects meta-analysis was performed to estimate the odds ratio of the incidence of falls in older adults with cognitive frailty. Results: Seven studies were included. The overall quality of the included studies was acceptable. The meta-analysis of cohort studies showed older adults aged 60 and above with cognitive frailty had a pooled odds ratio of 1.45 (95% confidence interval 1.30, 1.61) for at least one fall compared with those without cognitive frailty. The meta-analysis of cross-sectional studies showed that the odds of older adults with cognitive frailty experiencing at least one fall was 1.64 times (95% confidence interval 1.51, 1.79) higher than those without cognitive frailty. Conclusion: The association between cognitive frailty and the risk of falls is statistically significant. Timely detection of cognitive frailty is essential especially in the community nursing level for preventing falls.