Effect of exercise and cognitive training on falls and fall-related factors in older adults with mild cognitive impairment: A systematic review

Publication date: Available online 26 May 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Donald S. Lipardo, Anne Marie C. Aseron, Marcella M. Kwan, William W.N. Tsang
ObjectiveTo evaluate the effect of exercise and cognitive training on falls reduction and on factors known to be associated with falls among community-dwelling older adults with mild cognitive impairment (MCI).Data sourcesSeven databases (PubMed, CINAHL, Cochrane Library, Web of Science, ProQuest, ProQuest Dissertations and Theses, and Digital Dissertation Consortium) and reference lists of pertinent articles were searched.Study selectionRandomized controlled trials (RCTs) on the effect of exercise, cognitive training or combination of both on falls and factors associated with falls such as balance, lower limb muscle strength, gait and cognitive function among community-dwelling older adults with MCI were included.Data extractionData were extracted using the modified JBI-MAStARI tool. Study quality was assessed using the JBI-MAStARI appraisal instrument.Data synthesisSeventeen RCTs (1679 participants; mean age of 74.4 ±2.4) were included. Exercise improved gait speed and global cognitive function in MCI; both are known factors associated with falls. Cognitive training alone had no significant effect on cognitive function while combined exercise and cognitive training improved balance in MCI. Neither fall rate nor the number of fallers was reported in any of the studies included.ConclusionsThis review suggests that exercise, and combined exercise and cognitive training improve specific factors associated with falls such as gait speed, cognitive function, and balance, in MCI. Further research on the direct effect of exercise and cognitive training on fall rate and incidence in older adults with MCI with larger sample size is highly recommended.



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