Systematic Review of the Effects of Cognitive and Behavioural Interventions on Fall-Related Psychological Concerns in Older Adults

This systematic review aims to evaluate the efficacy of cognitive and behavioural interventions for improving falls-related psychological concerns. A systematic search yielded 8 randomised controlled trials eligible for inclusion. All studies compared a cognitive and behavioural intervention to a co...

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Bibliographic Details
Published in:Journal of aging and physical activity 2020-02, Vol.28 (1), p.155-168
Main Authors: Papadimitriou, Angela, Perry, Mark
Format: Article
Language:English
Subjects:
Accidental Falls
Aged
Anxiety - prevention & control
Anxiety - psychology
Behavior modification
Clinical significance
Clinical trials
Cognitive Behavioral Therapy
Cognitive-behavioral factors
Efficacy
Falls
Fear & phobias
Fear - psychology
Humans
Intervention
Older people
Systematic review
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Summary:This systematic review aims to evaluate the efficacy of cognitive and behavioural interventions for improving falls-related psychological concerns. A systematic search yielded 8 randomised controlled trials eligible for inclusion. All studies compared a cognitive and behavioural intervention to a control. Meta-analysis showed that cognitive and behavioural treatments had beneficial effects on fear of falling outcomes [lower score better] immediately after treatment [random effects standardised mean difference (SMD): -0.3 (95% CI: -0.50 to -0.10)] and at longer term follow up [random effects SMD: -0.29 (95% CI: -0.49 to -0.09)]. Cognitive and behavioural treatments also showed a positive effect on falls efficacy outcomes [higher score better] immediately after treatment [fixed effects SMD: 0.19 (95% CI: 0.04 to 0.34)] and over the longer term [fixed effects SMD: 0.13 (95% CI:-0.00 to 0.25)]. However the clinical significance of these effects on fear of falling and falls efficacy was unclear. Further work is required with best-practice comparators over a longer follow-up period.
ISSN:1063-8652
1543-267X
DOI:10.1123/japa.2017-0408