Systematic Review And Meta Analysis

Running head: NURSING
Assessment Task 3
Name of the Student
Name of the University
Author Note

1NURSING
Assessment Task 1
The specific area of practice in which I have particular interest is aged care.
According to the World Health Organization (WHO) (2019), in the coming decade, the
percentage of the elderly population is going to double (from 12% to 22%) and thus
outnumbering the percentage of children who are younger than 5 years. Increase in the
percentage of older adults is associated with several age health-related conditions commonly
known as geriatric syndromes. One of the common geriatric syndromes is dementia.
Dementia is a neurodegenerative disorder that has no cure. Older adults who are suffering
from dementia experience frailty and are vulnerable to accidental falls. Petersen et al. (2018)
and Fernando et al. (2017) stated that dementia doubles the risk of fall among the older adults
living at home or under residential care set-up or assisted care living. Encountering accidental
fall leads to fatal injuries and thereby hampering the health-related quality of life. This
highlights the need for further effective fall prevention of along with interventions for falls
especially for the older adults with dementia. A critical review of literature is important in
order to evaluate the clinical effectiveness along with the cost-effectiveness of fall prevention
initiatives among the older adults with dementia. The main domains of the fall prevention
strategy that will be targeted include mild to moderate physical exercise. The systematic
review conducted by Fernando et al. (2017) showed that the risk factors like balance, gait,
vision and functional status increase the vulnerability of accidental fall among the older
adults with dementia. Wheatley et al. (2019) revealed in their study that physical exercise in
general is helpful for adults to increase the level of physical fitness, irrespective of their age.
Thus, the main intervention that will targeted in this study is mild to moderate physical
exercise for the older adults.

2NURSING
Task 2
Research Question
What is the clinical effectiveness of mild to moderate physical exercise over the older adults
with dementia for decreasing the vulnerability of accidental fall?
PICO question
Population (P) Older adults with dementia
Intervention (I) Physical exercise as fall prevention strategies
Comparison (C) No physical exercise
Outcomes (O) Decreased incidence of accidental falls
Conduction of Research
Databases selected for research
CINAHL and PubMed
Keywords used for database research
Keyword 1: Physical exercise OR Physical activity OR exercise
[AND]
Keyword 2: Risk of falling OR Accidental fall OR Falls
[AND]
Keyword 3: Dementia OR Alzheimer
[AND]
Keyword 4: Older adults OR Aged care OR Geriatric OR Old

3NURSING
Inclusion and Exclusion Criteria
Inclusion Criteria Exclusion Criteria
Population: Older adults who are above 60
years of age
Below 60 years of age
Disease: Dementia Or Alzheimer Or
Cognitive impairment
Not significant disease condition
Intervention: Physical exercise Other intervention apart from physical
exercise
Language: English Apart from English
Type of Paper: Both Qualitative and
Quantitative
Grey literatures and Dissertation and Case
studies
Year of publication: Last 10 years (2010 to
2020)
Papers published before 2010
Peer-reviewed Non-peer-reviewed
List of three selected articles highlighted through database search
Sr.
No
.
Level of
Evidenc
e
List of Papers Justification Behind selection
1 Level 1b Toots, A., Wiklund, R., Littbrand, H.,
Nordin, E., Nordström, P., Lundin-
Olsson, L., ... & Rosendahl, E. 2019,
‘The effects of exercise on falls in older
people with dementia living in nursing
homes: A randomized controlled trial’,
Journal of the American Medical
Directors Association, vol. 20, no. 7, pp.
Falls under level 1b of
hierarchy. I has conducted
randomized control trial and this
helps to retrieved unbiased
results in comparison to the
other study design