Abstract：
People living with dementia (PWD) are at a heightened risk for falls. However, the effects of exercise on falls in PWD are unclear.
To conduct a systematic review of randomized controlled trials (RCTs) examining the efficacy of exercise to reduce falls, recurrent falls, and injurious falls relative to usual care among PWD.
We included peer-reviewed RCTs evaluating any exercise mode on falls and related injuries among medically diagnosed PWD aged ≥55years (international prospective register of systematic reviews (PROSPERO) ID:CRD42021254637). We excluded studies that did not solely involve PWD and were not the primary publication examining falls. We searched the Cochrane Dementia and Cognitive Improvement Group\'s Specialized Register and grey literature on 08/19/2020 and 04/11/2022; topical categories included dementia, exercise, RCTs, and falls. We evaluated the risk of bias (ROB) using the Cochrane ROB Tool-2 and study quality using the Consolidated Standards of Reporting Trials.
Twelve studies were included (n = 1,827; age = 81.3±7.0 years; female = 59.3%; Mini-Mental State Examination = 20.1±4.3 points; intervention duration = 27.8±18.5 weeks; adherence = 75.5±16.2%; attrition = 21.0±12.4%). Exercise reduced falls in two studies [Incidence Rate Ratio (IRR) range = 0.16 to 0.66; fall rate range: intervention = 1.35-3.76 falls/year, control = 3.07-12.21 falls/year]; all other studies (n = 10) reported null findings. Exercise did not reduce recurrent falls (n = 0/2) or injurious falls (n = 0/5). The RoB assessment ranged from some concerns (n = 9) to high RoB (n = 3); no studies were powered for falls. The quality of reporting was good (78.8±11.4%).
There was insufficient evidence to suggest that exercise reduces falls, recurrent falls, or injurious falls among PWD. Well-designed studies powered for falls are needed.
To conduct a systematic review of randomized controlled trials (RCTs) examining the efficacy of exercise to reduce falls, recurrent falls, and injurious falls relative to usual care among PWD.
We included peer-reviewed RCTs evaluating any exercise mode on falls and related injuries among medically diagnosed PWD aged ≥55years (international prospective register of systematic reviews (PROSPERO) ID:CRD42021254637). We excluded studies that did not solely involve PWD and were not the primary publication examining falls. We searched the Cochrane Dementia and Cognitive Improvement Group\'s Specialized Register and grey literature on 08/19/2020 and 04/11/2022; topical categories included dementia, exercise, RCTs, and falls. We evaluated the risk of bias (ROB) using the Cochrane ROB Tool-2 and study quality using the Consolidated Standards of Reporting Trials.
Twelve studies were included (n = 1,827; age = 81.3±7.0 years; female = 59.3%; Mini-Mental State Examination = 20.1±4.3 points; intervention duration = 27.8±18.5 weeks; adherence = 75.5±16.2%; attrition = 21.0±12.4%). Exercise reduced falls in two studies [Incidence Rate Ratio (IRR) range = 0.16 to 0.66; fall rate range: intervention = 1.35-3.76 falls/year, control = 3.07-12.21 falls/year]; all other studies (n = 10) reported null findings. Exercise did not reduce recurrent falls (n = 0/2) or injurious falls (n = 0/5). The RoB assessment ranged from some concerns (n = 9) to high RoB (n = 3); no studies were powered for falls. The quality of reporting was good (78.8±11.4%).
There was insufficient evidence to suggest that exercise reduces falls, recurrent falls, or injurious falls among PWD. Well-designed studies powered for falls are needed.
摘要：
背景：患有痴呆症（PWD）的人跌倒的风险更高。然而,运动对PWD患者跌倒的影响尚不清楚.
目的：对随机对照试验（RCT）进行系统评价，以检查运动减少跌倒的功效，反复跌倒,PWD中相对于常规护理的伤害性跌倒。
方法：我们纳入了同行评审的RCT，评估医学诊断为年龄≥55岁的PWD中跌倒和相关损伤的任何运动模式（国际前瞻性系统评价注册（PROSPERO）ID：CRD42021254637）。我们排除了不仅涉及PWD且不是主要研究跌倒的研究。我们在2020年8月19日和2022年4月11日搜索了Cochrane痴呆症和认知改善小组的专业注册和灰色文献；主题类别包括痴呆症，锻炼,RCT,和瀑布。我们使用CochraneROBTool-2评估偏倚风险（ROB），并使用合并报告试验标准评估研究质量。
结果：纳入了12项研究（n=1,827；年龄=81.3±7.0岁；女性=59.3％；简易精神状态检查=20.1±4.3分；干预持续时间=27.8±18.5周；依从性=75.5±16.2％；减员=21.0±12.4％）。在两项研究中，运动减少了跌倒[发生率比率（IRR）范围=0.16至0.66；跌倒率范围：干预=1.35-3.76跌倒/年，对照=3.07-12.21下降/年]；所有其他研究（n=10）报告的结果无效。运动不能减少反复跌倒（n=0/2）或伤害性跌倒（n=0/5）。RoB评估范围从一些问题（n=9）到高RoB（n=3）;没有研究支持跌倒。报告质量良好(78.8±11.4%)。
结论：没有足够的证据表明运动可以减少跌倒，反复跌倒,或PWD中的伤害性跌倒。需要精心设计的跌倒研究。
目的：对随机对照试验（RCT）进行系统评价，以检查运动减少跌倒的功效，反复跌倒,PWD中相对于常规护理的伤害性跌倒。
方法：我们纳入了同行评审的RCT，评估医学诊断为年龄≥55岁的PWD中跌倒和相关损伤的任何运动模式（国际前瞻性系统评价注册（PROSPERO）ID：CRD42021254637）。我们排除了不仅涉及PWD且不是主要研究跌倒的研究。我们在2020年8月19日和2022年4月11日搜索了Cochrane痴呆症和认知改善小组的专业注册和灰色文献；主题类别包括痴呆症，锻炼,RCT,和瀑布。我们使用CochraneROBTool-2评估偏倚风险（ROB），并使用合并报告试验标准评估研究质量。
结果：纳入了12项研究（n=1,827；年龄=81.3±7.0岁；女性=59.3％；简易精神状态检查=20.1±4.3分；干预持续时间=27.8±18.5周；依从性=75.5±16.2％；减员=21.0±12.4％）。在两项研究中，运动减少了跌倒[发生率比率（IRR）范围=0.16至0.66；跌倒率范围：干预=1.35-3.76跌倒/年，对照=3.07-12.21下降/年]；所有其他研究（n=10）报告的结果无效。运动不能减少反复跌倒（n=0/2）或伤害性跌倒（n=0/5）。RoB评估范围从一些问题（n=9）到高RoB（n=3）;没有研究支持跌倒。报告质量良好(78.8±11.4%)。
结论：没有足够的证据表明运动可以减少跌倒，反复跌倒,或PWD中的伤害性跌倒。需要精心设计的跌倒研究。
