Effectiveness of cognitive behaviour therapy-based multicomponent interventions on fear of falling among community-dwelling older adults: A systematic review and meta-analysis

doi:10.1111/jan.14150

Meta-Analysis

. 2019 Dec;75(12):3299-3315.

doi: 10.1111/jan.14150. Epub 2019 Aug 27.

Effectiveness of cognitive behaviour therapy-based multicomponent interventions on fear of falling among community-dwelling older adults: A systematic review and meta-analysis

Claris Hui Min Chua¹, Ying Jiang¹, Der Shin Lim¹, Vivien Xi Wu¹, Wenru Wang¹

Affiliations

PMID: 31287182
DOI: 10.1111/jan.14150

Meta-Analysis

Effectiveness of cognitive behaviour therapy-based multicomponent interventions on fear of falling among community-dwelling older adults: A systematic review and meta-analysis

Claris Hui Min Chua et al. J Adv Nurs. 2019 Dec.

. 2019 Dec;75(12):3299-3315.

doi: 10.1111/jan.14150. Epub 2019 Aug 27.

Authors

Claris Hui Min Chua¹, Ying Jiang¹, Der Shin Lim¹, Vivien Xi Wu¹, Wenru Wang¹

Affiliation

¹ Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

PMID: 31287182
DOI: 10.1111/jan.14150

Abstract
in English, Chinese

Aims: To systematically review the evidence and determine the effectiveness of cognitive behaviour therapy-based multicomponent interventions on fear of falling and falls among community-dwelling older adults who are at risk of falling.

Design: A systematic review and meta-analysis.

Data sources: Six electronic databases, including CENTRAL, CINAHL, EMBASE, PubMed, PsycInfo and Scopus, were searched. Studies published in English from January 1998-July 2018 were included in this review.

Review methods: Only randomized controlled trials addressing fear of falling and/or the occurrence of falls using cognitive behaviour therapy-based multicomponent interventions were included. A standard procedure based on the Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias of the selected studies. A meta-analysis was performed to determine the effectiveness of cognitive behaviour therapy-based multicomponent interventions on fear of falling immediately after the interventions, at ≤6 months and >6 months postinterventions.

Results: This review included 15 randomized controlled trials involving 3,165 community-dwelling adults aged 60 years and older. The pooled results showed that the intervention effects, including immediate, short-term (i.e., ≤6 months postintervention) and long-term (i.e., >6 months postintervention) effects, favoured the intervention group.

Conclusion: Cognitive behaviour therapy-based multicomponent interventions are effective at reducing fear of falling among community-dwelling older adults who are at risk of falling.

Impact: Fear of falling has been implicated in activity restriction among older adults and fall prevention interventions need to be multifaceted. Understanding and attending to individual psychological needs are as important as exercise training.

目的: 对证据进行系统性评价,并且,确定基于认知行为疗法的多因素干预措施对有跌倒危险的社区老年人的跌倒恐惧和跌倒的效果。设计: 系统性评价和荟萃分析。资料来源: 对CENTRAL、CINAHL、EMBASE、PubMed、PsycInfo与Scopus等6个电子数据库进行了检索。本次评价涵盖了1998年1月至2018年7月发表的英文研究报告。综述方法: 仅包括使用基于认知行为疗法的多因素干预措施治疗跌倒恐惧和/或应对跌倒发生的随机对照试验。将根据“考昆干预措施系统性评价手册”制定的标准程序用于评估所选研究的偏倚风险。进行荟萃分析,以确定,在干预后≤6个月和>6个月期间,基于认知行为疗法的多因素干预措施对跌到恐惧的效果。结果: 本次评价包括15项随机对照试验,涉及3165位60岁及以上的社区居民。综合结果表明,干预组在近期、短期(即,干预后≤6个月)和远期(即,干预后>6个月)效果上优于对照组。结论: 基于认知行为疗法的多因素干预措施能有效降低有跌倒危险的社区老年人的跌倒恐惧。影响: 老年人活动受限与害怕跌倒有关,预防跌倒的干预措施需要从多方面考虑。理解和关注个人的心理需求与理解和关注个人的运动训练一样重要。.

Keywords: cognitive behaviour therapy; community-dwelling older adults; falls; fear of falling; meta-analysis; nursing; systematic review.

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References

REFERENCES

1. Arkkukangas, M., Soderlund, A., Eriksson, S., & Johansson, A. C. (2018). Fall dcommunity-dwelling older adults: A randomized controlled trial with short-term follow-up. Journal of Geriatric Physical Therapy, 42(1), 9-17. https://doi.org/10.1519/JPT.0000000000000129
1. Arnold, C. M., Faulkner, R. A., & Gyurcsik, N. C. (2011). The relationship between falls efficacy and improvement in fall risk factors following an exercise plus educational intervention for older adults with hip osteoarthritis. Physiotherapy Canada, 63(4), 41-420. https://doi.org/10.3138/ptc.2010-29
1. Beck, J. S., & Beck, A. T. (2011). Cognitive behavior therapy, second edition: Basics and beyond, 2nd ed. New York: The Guilford Press.
1. Brilleman, L. S., Pachana, A. N., & Dobson, J. A. (2010). The impact of attrition on the representativeness of cohort studies of older people. BMC Medical Research Methodology, 10, 71. https://doi.org/10.1186/1471-2288-10-71
1. Cederbom, S., Rydwik, E., Söderlund, A., Denison, E., Frändin, K., & von Heideken Wågert, P. (2014). A behavioral medicine intervention for older women living alone with chronic pain - A feasibility study. Clinical Interventions in Aging, 9, 1383-1397. https://doi.org/10.2147/CIA.S66943

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[1] Arkkukangas, M., Soderlund, A., Eriksson, S., & Johansson, A. C. (2018). Fall dcommunity-dwelling older adults: A randomized controlled trial with short-term follow-up. Journal of Geriatric Physical Therapy, 42(1), 9-17. https://doi.org/10.1519/JPT.0000000000000129

[2] Arkkukangas, M., Soderlund, A., Eriksson, S., & Johansson, A. C. (2018). Fall dcommunity-dwelling older adults: A randomized controlled trial with short-term follow-up. Journal of Geriatric Physical Therapy, 42(1), 9-17. https://doi.org/10.1519/JPT.0000000000000129

[3] Arnold, C. M., Faulkner, R. A., & Gyurcsik, N. C. (2011). The relationship between falls efficacy and improvement in fall risk factors following an exercise plus educational intervention for older adults with hip osteoarthritis. Physiotherapy Canada, 63(4), 41-420. https://doi.org/10.3138/ptc.2010-29

[4] Arnold, C. M., Faulkner, R. A., & Gyurcsik, N. C. (2011). The relationship between falls efficacy and improvement in fall risk factors following an exercise plus educational intervention for older adults with hip osteoarthritis. Physiotherapy Canada, 63(4), 41-420. https://doi.org/10.3138/ptc.2010-29

[5] Beck, J. S., & Beck, A. T. (2011). Cognitive behavior therapy, second edition: Basics and beyond, 2nd ed. New York: The Guilford Press.

[6] Beck, J. S., & Beck, A. T. (2011). Cognitive behavior therapy, second edition: Basics and beyond, 2nd ed. New York: The Guilford Press.

[7] Brilleman, L. S., Pachana, A. N., & Dobson, J. A. (2010). The impact of attrition on the representativeness of cohort studies of older people. BMC Medical Research Methodology, 10, 71. https://doi.org/10.1186/1471-2288-10-71

[8] Brilleman, L. S., Pachana, A. N., & Dobson, J. A. (2010). The impact of attrition on the representativeness of cohort studies of older people. BMC Medical Research Methodology, 10, 71. https://doi.org/10.1186/1471-2288-10-71

[9] Cederbom, S., Rydwik, E., Söderlund, A., Denison, E., Frändin, K., & von Heideken Wågert, P. (2014). A behavioral medicine intervention for older women living alone with chronic pain - A feasibility study. Clinical Interventions in Aging, 9, 1383-1397. https://doi.org/10.2147/CIA.S66943

[10] Cederbom, S., Rydwik, E., Söderlund, A., Denison, E., Frändin, K., & von Heideken Wågert, P. (2014). A behavioral medicine intervention for older women living alone with chronic pain - A feasibility study. Clinical Interventions in Aging, 9, 1383-1397. https://doi.org/10.2147/CIA.S66943

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Effectiveness of cognitive behaviour therapy-based multicomponent interventions on fear of falling among community-dwelling older adults: A systematic review and meta-analysis

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Effectiveness of cognitive behaviour therapy-based multicomponent interventions on fear of falling among community-dwelling older adults: A systematic review and meta-analysis

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Abstract
in English, Chinese

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Abstract in English, Chinese

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in English, Chinese