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

in Journal of Aging and Physical Activity

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Angela Papadimitriou
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Mark Perry
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DOI:
https://doi.org/10.1123/japa.2017-0408
Keywords:
balance confidence; cognitive behavioral therapy; falls efficacy; fear of falling
In Print:
Volume 28: Issue 1
Page Range:
155–168
Restricted access

This systematic review aims to evaluate the efficacy of cognitive and behavioral interventions for improving fall-related psychological concerns. A systematic search yielded eight randomized controlled trials eligible for inclusion. All studies compared a cognitive and behavioral intervention with a control. The meta-analysis showed that cognitive and behavioral treatments had beneficial effects on fear of falling outcomes (lower score better) immediately after treatment (random-effects standardized mean difference [SMD]: −0.3, 95% confidence interval [CI] [−0.50, −0.10]) and at the longer term follow-up (random-effects SMD: −0.29, 95% CI [−0.49, −0.09]). Cognitive and behavioral 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, 0.34]) and over the longer term (fixed-effects SMD: 0.13, 95% CI [−0.00, 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.

Papadimitriou is with Health & Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore. Perry is with National Guideline Centre, Royal College of Physicians, London, United Kingdom.

Papadimitriou (angela.papadimitriou@singaporetech.edu.sg) is the corresponding author.
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