Preventing falls among older people with mental health problems: a systematic review

BMC Nursing

Christina Victor²  Wendy Martin²  Caroline Griffiths³  Deborah Humphrey³  Venkat Narayanan³  Charles Simpson¹  Angela Dickinson¹  Frances Bunn¹ 

[1] Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, Hertfordshire AL10 9AB, UK;School of Health Sciences and Social Care, Brunel University, Uxbridge UB8 3PH, UK;Oxford Health NHS Foundation Trust, Fulbrooke Centre, Churchill Hospital, Oxford OX3 7JX, UK

关键词: Mental health;    Older people;    Falls;    Systematic review;   

Others  :  1091340
DOI  :  10.1186/1472-6955-13-4

 received in 2013-06-13, accepted in 2014-02-10,  发布年份 2014

【 摘 要 】

Background

Falls are a leading cause of mortality and morbidity in older people and the risk of falling is exacerbated by mental health conditions. Existing reviews have focused on people with dementia and cognitive impairment, but not those with other mental health conditions or in mental health settings. The objective of this review is to evaluate the effectiveness of fall prevention interventions for older people with mental health problems being cared for across all settings.

Methods

A systematic review of fall prevention interventions for older people with mental health conditions. We undertook electronic database and lateral searches to identify studies reporting data on falls or fall related injuries. Searches were initially conducted in February 2011 and updated in November 2012 and October 2013; no date restrictions were applied. Studies were assessed for risk of bias. Due to heterogeneity results were not pooled but are reported narratively.

Results

Seventeen RCTs and four uncontrolled studies met the inclusion criteria; 11 involved single interventions and ten multifactorial. Evidence relating to fall reduction was inconsistent. Eight of 14 studies found a reduction in fallers (statistically significant in five), and nine of 14 reported a significant reduction in rate or number of falls. Four studies found a non-significant increase in falls. Multifactorial, multi-disciplinary interventions and those involving exercise, medication review and increasing staff awareness appear to reduce the risk of falls but evidence is mixed and study quality varied. Changes to the environment such as increased supervision or sensory stimulation to reduce agitation may be promising for people with dementia but further evaluation is needed. Most of the studies were undertaken in nursing and residential homes, and none in mental health hospital settings.

Conclusions

There is a dearth of falls research in mental health settings or which focus on patients with mental health problems despite the high number of falls experienced by this population group. This review highlights the lack of robust evidence to support practitioners to implement practices that prevent people with mental health problems from falling.

【 授权许可】

   
2014 Bunn et al.; licensee BioMed Central Ltd.

【 图 表 】

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