Effects of digital-based exercise interventions on concerns about falling, falls efficacy and physical performance among older adults: A systematic review and meta-analysis
ABSTRACT
Background:
Fear of falling (FOF) is a common psychological syndrome in older adults and consists of two distinct cognitive (e.g., low balance confidence) and affective (e.g., high concern about falling) constructs. The impact of digital-based interventions on these specific constructs remains unclear.
Objective:
This systematic review and meta-analysis aimed to synthesize current evidence on digital-based interventions for fear of falling among older adults, with a specific focus on determining their differential effects on the cognitive and affective constructs of fear of falling and evaluating their impact on physical performance.
Methods:
The PubMed, Web of Science, Cochrane Library, EMBASE, PsycINFO, CINAHL, CNKI, SinoMed, VIP and Wanfang databases were systematically searched from their inception dates to May 2025. We searched for published randomized controlled trials on the effects of digital-based interventions on the fear of falling among older adults. The study followed PRISMA guidelines and was performed with Stata 17.0 software.
Results:
Twenty-two studies involving 2,838 participants were included. Meta-analyses revealed significant effects of digital-based interventions on the cognitive constructs of fear of falling (SMD=-0.47, 95% CI [-0.70, -0.24], P<0.001), balance function (MD=3.89, 95% CI [2.32, 5.45], P<0.001), functional mobility (MD=-1.50, 95% CI [-2.33, -0.67], P<0.001) and physical function (MD=0.44, 95% CI [0.07, 0.81], P=0.020) in older adults. However, digital-based interventions had no significant effect on affective constructs of fear of falling (SMD=-0.18, 95% CI [-0.44, 0.08], P=0.176).
Conclusions:
The meta-analysis assessed the efficacy of digital-based interventions on the fear of falling among older adults and revealed that the effects differed across the constructs. These findings suggest that digital-based interventions have potential benefits for improving the cognitive constructs of fear of falling and physical performance among older adults compared with controls. However, the impact of digital-based interventions on affect-based constructs of fear of falling among older adults remains uncertain. Clinical Trial: The study protocol was registered in PROSPERO (CRD42024567108).
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