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Lookup NU author(s): Dr Gill NormanORCiD, Dr Emma Vardy
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
© The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society. OBJECTIVE: 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.
Author(s): Eost-Telling C, McNally L, Yang Y, Shi C, Norman G, Ahmed S, Poku B, Money A, Hawley-Hague H, Todd CJ, Shenkin SD, Vardy ERLC
Publication type: Article
Publication status: Published
Journal: Age and Ageing
Year: 2024
Volume: 53
Issue: 12
Online publication date: 17/12/2024
Acceptance date: 13/10/2024
Date deposited: 06/01/2025
ISSN (electronic): 1468-2834
Publisher: Oxford University Press
URL: https://doi.org/10.1093/ageing/afae270
DOI: 10.1093/ageing/afae270
Data Access Statement: This is a review of previously published studies; therefore, all the data used in the review are already in the public domain. All data relevant to the included studies are included in the article or uploaded as supplementary information.
PubMed id: 39686680
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