A Systematic Review of Falls Risk of Frail Patients with Dementia in Hospital: Progress, Challenges, and Recommendations

Naomi Davey,1 Eimear Connolly,1 Paul Mc Elwaine,1,2 Sean P Kennelly1,2 1Department of Age Related Healthcare, Tallaght University Hospital, Dublin, Ireland; 2Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, IrelandCorrespondence: Naomi Davey, Department of Age-Related Healthcare, Tallaght University Hospital, Dublin, Ireland, Email Naomi.davey@tuh.ieAbstract: This review article assesses the effectiveness and limitations of strategies to reduce falls among hospitalized older adults with frailty and dementia. It explores the efficacy of existing fall prevention strategies for a cohort that is acutely susceptible to falls and fall-related consequences. A systematic literature search was conducted across MEDLINE, Embase, CINAHL, and PsycINFO, employing Medical Subject Headings (MeSH) to identify studies on fall prevention strategies in hospitalized older adults with both dementia and frailty published from 2013 to 2023. The initial 643 records were distilled to eight articles, with Structured Interdisciplinary Bedside Rounds (SIBR) emerging as a notable intervention. SIBR demonstrated a reduction in falls by fostering improved interdisciplinary communication and care planning. However, a decline in family engagement during consecutive sessions suggests a need for strategies to sustain familial involvement. The findings advocate for patient-centered interventions that address the cognitive and functional challenges faced by this cohort of older adults. This review advocates for comprehensive and inclusive research in hospital environments to improve fall prevention strategies for frail older adults with dementia.Keywords: fall prevention, frailty, dementia, hospitalized older adults, interdisciplinary collaboration, patient-centered interventions