Summary of best evidence on fall interventions for older adults with dementia in long-term care institutions.

BACKGROUND

Falls in older adults with dementia significantly reduce their quality of life and increase the burden on long-term care. This study aims to systematically identify, critically appraise, and synthesize the best available evidence on fall prevention and management for older adults with dementia residing in long-term care institutions, with the goal of providing concrete, actionable evidence-based guidance to inform clinical practice and improve the quality of care.

METHODS

According to the '6S' evidence model, a top-down search strategy was employed to identify relevant evidence resources, including systematic reviews, guidelines, best practice, evidence summaries and expert consensus. The search encompassed records from the inception of each database up to December 31, 2024. Two reviewers independently screened, quality-appraised, and extracted evidence, which was synthesized using the JBI system.

RESULTS

A total of 9 articles was included (1 expert consensus and 8 systematic reviews). After quality evaluation, 46 pieces of evidence were extracted and further consolidated into 29 evidence statements across six dimensions.

CONCLUSION

This evidence summary provides six key recommendations for fall prevention in older adults with dementia in long-term care facilities, including risk factor assessment, staff training and education, exercise intervention, strengthening supervision, dementia care mapping, and environmental intervention. These findings offer a practical, evidence-based framework to guide clinical practice, reduce fall-related adverse outcomes, and improve quality of life for this vulnerable population.