Effectiveness of cognitive behaviour therapy-based multicomponent interventions on fear of falling among community-dwelling older adults: A systematic review and meta-analysis

Aims To systematically review the evidence and determine the effectiveness of cognitive behaviour therapy-based multicomponent interventions on fear of falling and falls among community-dwelling older adults who are at risk of falling. Design A systematic review and meta-analysis. Data Sources Six electronic databases, including CENTRAL, CINAHL, EMBASE, PubMed, PsycInfo and Scopus, were searched. Studies published in English from January 1998-July 2018 were included in this review. Review Methods Only randomized controlled trials addressing fear of falling and/or the occurrence of falls using cognitive behaviour therapy-based multicomponent interventions were included. A standard procedure based on the Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias of the selected studies. A meta-analysis was performed to determine the effectiveness of cognitive behaviour therapy-based multicomponent interventions on fear of falling immediately after the interventions, at <= 6 months and >6 months postinterventions. Results This review included 15 randomized controlled trials involving 3,165 community-dwelling adults aged 60 years and older. The pooled results showed that the intervention effects, including immediate, short-term (i.e., <= 6 months postintervention) and long-term (i.e., >6 months postintervention) effects, favoured the intervention group. Conclusion Cognitive behaviour therapy-based multicomponent interventions are effective at reducing fear of falling among community-dwelling older adults who are at risk of falling. Impact Fear of falling has been implicated in activity restriction among older adults and fall prevention interventions need to be multifaceted. Understanding and attending to individual psychological needs are as important as exercise training.