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Abstract
Systematically review and critically appraise the evidence for the association between delirium and falls in community-dwelling adults aged ≥60 years.
Methods
We searched EMBASE, MEDLINE, PsycINFO, Cochrane Database of Systematic Reviews, CINAHL and Evidence-Based Medicine Reviews databases in April 2023. Standard methods were used to screen, extract data, assess risk of bias (using Newcastle–Ottawa scale), provide a narrative synthesis and, where appropriate, conduct meta-analysis.
Results
We included 8 studies, with at least 3505 unique participants. Five found limited evidence for an association between delirium and subsequent falls: one adjusted study showed an increase in falls (risk ratio 6.66; 95% confidence interval (CI) 2.16–20.53), but the evidence was low certainty. Four non-adjusted studies found no clear effect. Three studies (one with two subgroups treated separately) found some evidence for an association between falls and subsequent delirium: meta-analysis of three adjusted studies showed an increase in delirium (pooled odds ratio 2.01; 95% CI 1.52–2.66); one subgroup of non-adjusted data found no clear effect. Number of falls and fallers were reported in the studies. Four studies and one subgroup were at high risk of bias and one study had some concerns.
Conclusions
We found limited evidence for the association between delirium and falls. More methodologically rigorous research is needed to understand the complex relationship and establish how and why this operates bidirectionally. Studies must consider confounding factors such as dementia, frailty and comorbidity in their design, to identify potential modifying factors involved. Clinicians should be aware of the potential relationship between these common presentations.
Original language | English |
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Article number | afae270 |
Journal | Age and Ageing |
Volume | 53 |
Issue number | 12 |
DOIs | |
Publication status | Published - 17 Dec 2024 |
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Dementia and Ageing Research Team (DART)
Keady, J. (PI), Pusey, H. (Researcher), Burrow, S. (Researcher), Kindell, J. (Researcher), Clark, A. (Researcher) & Elvish, R. (Researcher)
Project: Research
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HARG: Healthy Ageing Research Group
Todd, C. (Researcher), Stanmore, E. (Researcher), Hall, A. (Researcher), Littlewood, A. (Researcher), Davies, A. (Researcher), Sowerbutts, A. M. (Researcher), Maharani, A. (Researcher), Dowding, D. (Researcher), Jones, D. (Researcher), Boulton, L. (Researcher), Cruickshank, F. (Researcher), Hawley-Hague, H. (Researcher), Brooks, J. (Researcher), Griffiths, J. (Researcher), Spencer, K. (Researcher), Fisher, K. (Researcher), Mcgarrigle, L. (Researcher), Cook, M. (Researcher), Pendleton, N. (Researcher), Stanford, P. (Researcher), Lasrado, R. (Researcher), Ahmed, S. (Researcher), Clinch, S. (Researcher), Burden, S. (Researcher), Gluchowski, A. (Researcher), Ford, C. (PGR student), Al Zadjali, F. (PGR student), Sremanakova, J. (PGR student), Fisher, K. (PGR student), Zougar, M. (PGR student), Almohaisen, N. (PGR student), Yang, Y. (PGR student), Mckenzie, Y. (PGR student), O'Connor, S. (Researcher), Aminu, A. (Researcher), Bosco, A. (Researcher), Parchment, A. (Researcher), Money, A. (Researcher), Mackenzie, A. (Researcher), Karki, B. (PGR student), Poku, B. (Researcher), Eost-Telling, C. (Researcher), French, C. (PGR student), Harris, D. (PGR student), Andah, E. (Researcher), Vardy, E. (Researcher), Hakeem, F. (Researcher), Donald, G. (Researcher), Bilsborough, H. (PGR student), Gangannagaripalli, J. (Researcher), Astbury, J. (Researcher), Garsden, J. (Researcher), Ventre, J. (Researcher), Aguilera Munoz, J. (Researcher), Allsopp, K. (Researcher), Mcgarrigle, L. (Researcher), Mott, L. (PGR student), Huang, L. (Researcher), Tomkow, L. (Researcher), Ahmed, N. (Researcher), Fox, S. (Researcher), Mcdermott, J. (Researcher), Hoodless, S. (Researcher), Dlima, S. (PGR student), Shi, Y. (PGR student) & Tang, Y. (PGR student)
Project: Research
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NIHR Applied Research Collaboration Greater Manchester.
Cullum, N. (PI), Abel, K. (CoI), Ainsworth, J. (CoI), Arden Armitage, C. (CoI), Bee, P. (CoI), Bower, P. (CoI), Bucci, S. (CoI), Burden, S. (CoI), Burns, A. (CoI), Checkland, K. (CoI), Dixon, W. (CoI), Dowding, D. (CoI), Dumville, J. (CoI), French, D. (CoI), Grande, G. (CoI), Green, J. (CoI), Griffiths, J. (CoI), Hodgson, D. (CoI), Keady, J. (CoI), Kislov, R. (CoI), Kontopantelis, E. (CoI), Lovell, K. (CoI), Meacock, R. (CoI), Morciano, M. (CoI), Munford, L. (CoI), O'Neill, T. (CoI), Peek, N. (CoI), Pendleton, N. (CoI), Sanders, C. (CoI), Spooner, S. (CoI), Stanmore, E. (CoI), Sutton, M. (CoI), Todd, C. (CoI), Turner, S. (CoI), Van Der Veer, S. (CoI), Webb, R. (CoI), Whittaker, W. (CoI) & Wilson, P. (CoI)
1/10/19 → 30/09/24
Project: Research