Development of an intervention to reduce falls in older adults with mild cognitive impairment (25 minutes, 5 minutes for questions), Ms Vicky Booth, Research Physiotherapist, University of Nottingham,

The gap

Consensus across the literature

Supporting evidence — 4 representative gaps

• Community-based interventions to support aging in place and functional independence in older adults: a systematic review of randomized controlled trials (2026) · doi

  Across the included studies, several consistent research gaps were identified. In physical activity interventions, many studies recom- mended larger and longer trials to assess sustained effects on mobility, falls self-efficacy, and cognitive outcomes (11, 37, 79, 80). Several authors emphasized the need to integrate mental health components within physical activity programs and to examine subgroup differ- ences, particularly among frailer adults and those with depressive symptoms (27, 81). Additional priorities included evaluating cultur- ally adapted models, combined nutrition and exercise strategies for sarcopenic obesity (39, 41, 65), and community-based fall prevention approaches (26, 63). In cognitive and psychological interventions, long-term follow-up was frequently recommended to determine the durability of memory and cognitive benefits, especially among populations with mild cogni- tive impairment and those at risk of dementia (97). Studies high- lighted the need to combine cognitive and physical training, expand culturally adapted peer-delivered models, and test integrated cognitive behavioral approaches in underserved populations (16, 17, 28, 45, 49, 53). Multidomain interventions were often accompanied by calls for larger RCTs examining combined physical, cognitive, and social com- ponents over extended follow-up periods (18, 55). Health education and chronic disease management interventions identified the need for further evaluation of healthcare utilization, sustained behavior change, and culturally adapted or peer-led delivery models (4, 58, 66, 68, 100). Several trials also recommended examin- ing the role of digital tools in enhancing accessibility and adherence, including telehealth platforms, mobile applications, and blended delivery formats, with particular attention to family and community involvement (29, 59, 60, 62, 63, 101). 4.3 Limitations This systematic review has several limitations. First, restricting inclusion to English-language publications may have introduced lan- guage bias and excluded relevant evidence published in other lan- guages. Second, although limiting the review to RCTs strengthened internal validity, this decision excluded observational and qualitative studies that could have provided important contextual insights into implementation processes, participant experiences, and real-world feasibility. In addition, methodological quality varied across included studies, including potential risks related to allocation concealment, blinding, attrition, and selective outcome reporting, which may have influenced effect estimates. Relatedly, the decision to exclude blinding domains (D4 and D5) from the overall study-level risk-of-bias clas- sification may have resulted in a more favorable quality profile than would have been obtained using stricter composite approaches, and this should be considered when interpreting the overall distribution of risk-of-bias ratings. Third, substantial heterogeneity in outcome measures, intervention designs, and follow-up durations posed chal- lenges for synthesis and limited comparability across studies. Independence was operationalized in diverse ways, ranging from objective physical performance measures to self-reported quality-of- life and psychosocial indicators, complicating the direct aggregation and interpretation of findings. Publication bias also remains a concern because trials with statistically significant findings are more likely to be published. As a result, null or negative studies may be underrepre- sented, potentially inflating estimates of effectiveness. Fourth, the predominance of studies conducted in high-income countries limits the geographic diversity of the evidence base and may constrain trans- ferability to low- and middle-income settings where community infra- structure, workforce capacity, service integration, and resource availability differ substantially. The relative underrepresentation of studies from lower-resource contexts restricts global generalizability, particularly in regions undergoing rapid demographic transition with distinct social support structures and health system configurations. In addition, many trials recruited community-dwelling older adults who were willing and able to participate in structured programs, which may reduce applicability to more socially isolated, cognitively impaired, or severely frail populations. Fifth, the limited follow-up duration in many studies constrains conclusions regarding the

  Keywords: cognitive physical several interventions trials community follow bias across included need health adapted models approaches
• Impact of an online-guided physical activity intervention on cognition, resting-state brain connectivity, and the gut microbiome in healthy older adults—a randomized controlled trial (2026) · doi

  One key limitation concerns the characteristics of our sample. Participants were generally very healthy, highly educated, and physically fit, reflect- ing the strict medical exclusion criteria required in our study and the resulting recruitment process, which led to a highly selected and relatively homo- geneous cohort with high baseline CRF levels. While these criteria strengthened internal validity, they may have reduced the potential for detecting between-group differences and limit generalizabil- ity to older adults with more diverse health profiles. This aligns with previous findings that larger effects of aerobic training are typically observed in more sedentary populations [13, 66]. Therefore, future studies could evaluate this intervention in less healthy or more sedentary populations, where larger effects may be expected. However, the observed cognitive and neural benefits suggest that even those with above-average fitness may still benefit from such interventions. A second limitation concerns the exploratory nature of the results regarding secondary outcome measures. This study was designed and powered specifically to evaluate the effect of the intervention on the primary outcome, change in visual process- ing speed. Analyses of secondary outcomes followed a purely exploratory approach and were conducted without correction for multiple comparisons. Thus, these findings should be interpreted with caution and considered hypotheses-generating, informing the design of future confirmatory studies. A third limitation concerns the requirement for participants in both groups to wear smartwatches. Although they were instructed that they had to wear the devices only during their assigned training ses- sions, this requirement may nonetheless have encour- aged increased physical activity outside the pre- scribed training, potentially reducing differences in overall activity levels between groups. The fourth limitation concerns adherence, which was assessed solely by the number of completed training sessions. Although the smartwatches used could have provided additional metrics (e.g., heart rate and energy expenditure), these were not ana- lyzed. Future studies may leverage such data to obtain more detailed insights into training intensity and physiological responses. Furthermore, dietary behavior was assessed only via self-report and not in detail, and therefore cannot be fully controlled for in the microbiome analyses. Then, while the monocentric design ensured meth- odological consistency, it may limit the generalizabil- ity of the findings to other populations and settings. Lastly, the requirement of a smartphone for data synchronization may represent a barrier to feasibility and scalability in future studies, particularly in older adult populations, although smartphone access is increasingly common.

  Keywords: training limitation concerns populations future requirement participants healthy highly criteria process levels differences limit generalizabil
• S-21: Palliative medicine (2015) · doi

  Development of an intervention to reduce falls in older adults with mild cognitive impairment (25 minutes, 5 minutes for questions), Ms Vicky Booth, Research Physiotherapist, University of Nottingham, UK: Evidence for effective falls prevention strategies for older adults with cognitive impairment remains sparse.

  Keywords: falls older adults cognitive impairment minutes development intervention reduce mild questions vicky booth physiotherapist university
• Ageing Joyfully: The Role of Physical Activity for Sustainable Healthy Ageing (2026) · doi

  COVID-19 pandemic, and several should be acknowledged. First, the data were self- reported, which may introduce social desirability and recall bias. Second, the cross-sectional design limits the ability to infer causal relationships between physical activity and healthy ageing among the rural elderly population. Third, the to all rural findings cannot be generalized populations, particularly those from differing cultural or socio-economic contexts, where physical activity and lifestyle choices may vary time and resources. depending on available Moreover, the post-pandemic environment posed exceptional challenges for the researcher, including restrictions on mobility, limited social interaction, and evolving public health guidelines during the data collection period. These factors may have influenced participants’ levels of physical activity, perceptions of happiness, and overall healthy ageing outcomes. Finally, this study focused primarily on the relationship between physical activity, happiness, and healthy ageing, and did not include an in-depth examination of other contributing factors such as social engagement, cognitive stimulation, or nutritional adequacy. Future studies should consider these dimensions to provide a more comprehensive understanding of healthy ageing in rural settings. Author’s Contribution Conceptualization – First and Second Author; Methodology – First Author; Validation – Second Author; Data analysis and data synthesis – First Author; Writing original draft preparation – First Author; Writing review and editing – First Author and Second Author; all authors have read and agreed to the published version of the manuscript. Conflicts of Interest. The author declared no conflict of interest. Funding. No funding was received for this research.

  Keywords: author first second physical activity healthy ageing social rural pandemic factors happiness writing interest funding