School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
Department of Statistics, The Chinese University of Hong Kong, Hong Kong, China.
Int J Nurs Pract. 2023 Aug;29(4):e13181. doi: 10.1111/ijn.13181. Epub 2023 Jul 12.
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.
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.
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.
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.
跌倒会导致许多不良健康后果，并危及老年人的身体功能和生活质量。认知障碍和身体虚弱被发现与跌倒风险相关，但没有系统评价评估认知脆弱与跌倒风险之间的关系。
于 2021 年 9 月 3 日在 Cochrane 图书馆、Scopus、CINAHL、EMBASE 和 PsycINFO 中进行了横断面、队列和病例对照研究的系统文献检索。使用 Joanna Briggs 研究所的批判性评估工具评估研究质量。采用随机效应荟萃分析来估计认知脆弱的老年人跌倒发生率的比值比。
共纳入 7 项研究。纳入研究的总体质量是可以接受的。队列研究的荟萃分析表明，与无认知脆弱的老年人相比，年龄在 60 岁及以上且有认知脆弱的老年人至少发生一次跌倒的合并比值比为 1.45（95%置信区间 1.30，1.61）。横断面研究的荟萃分析表明，有认知脆弱的老年人至少发生一次跌倒的可能性是无认知脆弱的老年人的 1.64 倍（95%置信区间 1.51，1.79）。
认知脆弱与跌倒风险之间存在统计学显著关联。及时发现认知脆弱对于预防跌倒至关重要，特别是在社区护理层面。
