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improve physical and cognitive function in dementia populations.
However, the effect on preventing falls in a dementia population is
conflicting. Combining a standard falls rehabilitation programme
with a cognitive component is a novel and emerging area of
health evidence. This presentation will summarise the results
of a systematic review that is currently being undertaken at
the University of Nottingham to evaluate the effectiveness of
combined cognitive and physical interventions on the risk of
falls in cognitively impaired older adults. This presentation will
also summarise research work from Nottingham, UK on the
development of a tailored falls prevention intervention for older
adults with cognitive impairment. This has been developed by
adapting conventional falls prevention strategies drawing on
neuropsychological rehabilitation techniques and informed by focus
groups and workshops comprising dementia-specialist therapists,
in addition to collaboration from rehabilitation therapists in the
areas of learning disabilities and traumatic brain injury.
3. Possibilities to reduce falls and fractures among people with
dementia
(25 minutes, 5 minutes for questions), Professor Kaisu
Pitk¨al¨a, University of Helsinki, Department of General Practice,
Finland: This presentation will summarise the evidence for
effectiveness and feasibility of interventions to reduce fall-related
fractures in dementia. The following types of interventions will
be discussed: (1) exercise interventions; (2) interventions to
reduce psychotropic medications and other drugs related to
falls; (3) nutritional guidance and vitamin D; (4) hip protectors;
and (5) environmental modifications. The presentation will also
summarise the findings of three randomised controlled trials that
have been performed in, and coordinated by the University of
Helsinki on both home-dwelling and institutionalised patients
with dementia. This will incorporate a discussion about how the
stage and severity of dementia are associated with the outcome
of the individual interventions. The presentation will also discuss
future prospects of intervention studies aiming to reduce falls in
dementia.
Conclusion:
This symposium explores new and emerging research
evidence addressing falls and fracture prevention in older adults
across the spectrum of cognitive impairment and dementia,
presented by clinicians with extensive experience of delivering
complex interventions in dementia cohorts in both clinical and
research settings. The learning objectives for this symposium are:
1. To identify and understand the role of specific cognitive factors
that contribute to falls risk in older adults with cognitive
impairment.
2. To share practical tips with regard to which neuropsychological
assessments to use to assist with risk stratification of this patient
cohort.
3. To understand and appraise the evidence for combined physical
and cognitive rehabilitation strategies to prevent falls in older
adults with cognitive impairment.
4. To share practical insights into developing and delivering
a neuropsychology-informed falls prevention intervention for
older adults with cognitive impairment.
5. To understand the role of exercise to reduce falls risk in older
adults with dementia, emphasising the duration and intensity of
intervention required.
6. To appraise the evidence for interventions to reduce falls and
fractures specific to an older population with dementia and to
highlight how these interventions differ in their effectiveness
depending on stage and severity of dementia.