Background: Falls are a significant cause of morbidity and mortality in older people with dementia due to declining physical and cognitive abilities, exposing to high fall risk. Informal Caregivers play a crucial role in fall prevention care and their knowledge, attitudes, and practices regarding fall prevention are vital for reducing fall risks. Evaluating caregivers' knowledge, attitudes, and practices in fall prevention benefits overall care for the recipients. Objective: To identify knowledge, attitudes and practices of informal Caregivers on fall prevention among older person with Dementia and the instruments used to access it. Methods: The Arksey and O’Malley (2005) framework for scoping reviews (PRISMA-ScR) guidelines was adapted. Three databases were included in the search for articles from 2013 to 2023. Two independent reviewers conducted study selection, article screening and data extraction. Extracted data summarised according to study aim. Results: Among the 280 analysed articles, only five were relevant to our review. Five articles assessed knowledge, four assessed attitude, and three included practices related to fall prevention. However, none of the articles reported the exact instruments used for assessing knowledge, attitude, and practice. Conclusion: Key findings indicate low knowledge on fall prevention among Informal Caregivers, although they hold a positive attitude. There is a lack of practice and a multidomain approach to fall prevention. Professional references are limited, and no valid instrument to assess caregivers' knowledge, attitude and practice in preventing falls among older persons with dementia. Recommendation: Future research should focus on psychoeducation in fall prevention involving Informal Caregivers and a multidomain approach. Developing a valid instrument is essential for evaluating intervention effectiveness.
Abdollahpour, I. , N. S. , & S. Y. (2018). Positive Aspects of Caregiving and Caregiver Burden: A Study of Caregivers of Patients With Dementia. Journal of Geriatric Psychiatry and Neurology, 31(1), 34–38. https://doi.org/https://doi.org/10.1177/0891988717743590
Amsalu, E. T., Messele, T. A., & Adane, M. (2021). Exploring the effect of professional experience on knowledge towards geriatric care among nurses working in adult care units. BMC Geriatrics, 21(1). https://doi.org/10.1186/s12877-021-02156-3
Anderson, J. G., Hundt, E., Dean, M., & Rose, K. M. (2019). “A Fine Line That We Walk Every Day”: Self-Care Approaches Used by Family Caregivers of Persons with Dementia. Issues in Mental Health Nursing, 40(3), 252–259. https://doi.org/10.1080/01612840.2018.1499156
Arksey, H., & O’Malley, L. (2005). Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19–32. https://doi.org/10.1080/1364557032000119616
Arvanitakis, Z., Shah, R. C., & Bennett, D. A. (2019). Diagnosis and Management of Dementia: Review. JAMA - Journal of the American Medical Association, 322(16), 1589–1599. https://doi.org/10.1001/jama.2019.4782
Bailes, C. O., Kelley, C. M., & Parker, N. M. (2016). Caregiver burden and perceived health competence when caring for family members diagnosed with Alzheimer’s disease and related dementia. Journal of the American Association of Nurse Practitioners, 28(10), 534–540. https://doi.org/https://doi.org/10.1002/2327-6924.12355
Balbim, G. M., Marques, I. G., Cortez, C., Magallanes, M., Rocha, J., & Marquez, D. X. (2019). Coping Strategies Utilized by Middle-Aged and Older Latino Caregivers of Loved Ones with Alzheimer’s Disease and Related Dementia. Journal of Cross-Cultural Gerontology, 34(4), 355–371. https://doi.org/10.1007/s10823-019-09390-8
Cations, M., Radisic, G., Crotty, M., & Laver, K. E. (2018). What does the general public understand about prevention and treatment of dementia? A systematic review of population-based surveys. PLOS ONE, 13(4), e0196085-. https://doi.org/10.1371/journal.pone.0196085
Chiao, C.-Y., Wu, H.-S., & Hsiao, C.-Y. (2015). Caregiver burden for ICG of patients with dementia: A systematic review. International Nursing Review, 62(3), 340–350. https://doi.org/https://doi.org/10.1111/inr.12194
Colombo, F., & Mercier, J. (2012). Help Wanted? Fair and Sustainable Financing of Long-term Care Services. Applied Economic Perspectives and Policy, 34(2), 316–332. http://www.jstor.org/stable/23273827
Daniel, O., Patricia, N., Dorah, N., Jemimah, N., Sebastian, O., & Stephen, K. (2021). Knowledge, Attitudes and Treatment Practices of Medical Doctors towards Care of Elderly Patients Accessing Clinical Care at Hospitals in Kampala Uganda. Journal of Geriatric Medicine and Gerontology, 7(2). https://doi.org/10.23937/2469-5858/1510114
De Avila, M. A. G., Pereira, G. J. C., & Bocchi, S. C. M. (2015). ICG of older people recovering from surgery for hip fractures caused by a fall: Fall prevention. Ciencia e Saude Coletiva, 20(6), 1901–1907. https://doi.org/10.1590/1413-81232015206.17202014
Dev, K., Javed, A., Bai, P., Murlidhar, ., Memon, S., Alam, O., & Batool, Z. (2021). Prevalence of Falls and Fractures in Alzheimer’s Patients Compared to General Population. Cureus. https://doi.org/10.7759/cureus.12923
Eloranta, S., Arve, S., Isoaho, H., Aro, I., Kalam-Salminen, L., & Routasalod, P. (2014). Finnish nurses’ perceptions of care of older patients. International Journal of Nursing Practice, 20(2), 204–211. https://doi.org/https://doi.org/10.1111/ijn.12137
ENGSTRÖM, M., SKYTT, B., & NILSSON, A. (2011). Working life and stress symptoms among caregivers in elderly care with formal and no formal competence. Journal of Nursing Management, 19(6), 732–741. https://doi.org/https://doi.org/10.1111/j.1365-2834.2011.01270.x
Feng, Z., Liu, C., Guan, X., & Mor, V. (2012). China’s rapidly aging population creates policy challenges in shaping a viable long-term care system. Health Affairs, 31(12), 2764–2773. https://doi.org/10.1377/hlthaff.2012.0535
Fernando, E., Fraser, M., Hendriksen, J., Kim, C. H., & Muir-Hunter, S. W. (2017). Risk factors associated with falls in older adults with dementia: A systematic review. In Physiotherapy Canada (Vol. 69, Issue 2, pp. 161–170). University of Toronto Press Inc. https://doi.org/10.3138/ptc.2016-14
Fernando, S. (2019). EXPLORING THE PREPAREDNESS OF FAMILY CAREGIVERS TO PROVIDE CANCER PALLIATIVE CARE. https://doi.org/10.5281/zenodo.3262110
Ferreira-Valente, M. A., Pais-Ribeiro, J. L., & Jensen, M. P. (2011). Validity of four pain intensity rating scales. PAIN®, 152(10), 2399–2404. https://doi.org/https://doi.org/10.1016/j.pain.2011.07.005
Fita, F., Mekonnen, H. S., Endalew, H. L., & Azagew, A. W. (2021). Knowledge, attitude, and associated factors towards older people care among nurses working at public hospitals in West Shoa zone, Oromia region, Ethiopia. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00774-1
Friedman, S. M., Menzies, I. B., Bukata, S. V, Mendelson, D. A., & Kates, S. L. (2010). Dementia and Hip Fractures: Development of a Pathogenic Framework for Understanding and Studying Risk. Geriatric Orthopaedic Surgery & Rehabilitation, 1(2), 52–62. https://doi.org/10.1177/2151458510389463
Gkioka, M., Schneider, J., Kruse, A., Tsolaki, M., Moraitou, D., & Teichmann, B. (2020). Evaluation and Effectiveness of Dementia Staff Training Programs in General Hospital Settings: A Narrative Synthesis with Holton’s Three-Level Model Applied. Journal of Alzheimer’s Disease, 78(3), 1089–1108. https://doi.org/10.3233/JAD-200741
K, K. (2017). Interventions for Caregivers of People with Dementia in Greece. Journal of Family Medicine, 4. https://doi.org/10.26420/jfammed.2017.1125
Kabatova, O., Putekova, S., Martinkova, J., & Záhorecová, H. (2016). Nurses’ attitudes and knowledge of the geriatric age issue. Kontakt, 18.
https://doi.org/10.1016/j.kontakt.2016.10.002
Kim, C.-J., Park, J., Kang, S.-W., & Schlenk, E. A. (2017). Factors affecting aging cognitive function among community-dwelling older adults. International Journal of Nursing Practice, 23(4), e12567. https://doi.org/10.1111/ijn.12567
Krishnamurthi, R. V., Dahiya, E. S., Bala, R., Cheung, G., Yates, S., & Cullum, S. (2022). Lived Experience of Dementia in the New Zealand Indian Community: A Qualitative Study with Family Caregivers and People Living with Dementia. International Journal of Environmental Research and Public Health, 19(3).
https://doi.org/10.3390/ijerph19031432
Lampe, L., Huppertz, H. J., Anderl-Straub, S., Albrecht, F., Ballarini, T., Bisenius, S., Mueller, K., Niehaus, S., Fassbender, K., Fliessbach, K., Jahn, H., Kornhuber, J., Lauer, M., Prudlo, J., Schneider, A., Synofzik, M., Kassubek, J., Danek, A., Villringer, A., … Schroeter, M. L. (2023). Multiclass prediction of different dementia syndromes based on multi-centric volumetric MRI imaging. NeuroImage: Clinical, 37.
https://doi.org/10.1016/j.nicl.2023.103320
Lim, S. C., Mamun, K., & Lim, J. K. H. (2014). Comparison between elderly inpatient fallers with and without dementia. Singapore Medical Journal, 55(2), 67–71.
https://doi.org/10.11622/smedj.2014017
Liu, Y., Dokos, M., Fauth, E. B., Lee, Y. G., & Zarit, S. H. (2019). Financial Strain, Employment, and Role Captivity and Overload over Time among Dementia Family Caregivers. Gerontologist, 59(5), e512–e520. https://doi.org/10.1093/geront/gnz099
Lloyd, J., Patterson, T., & Muers, J. (2014). The positive aspects of caregiving in dementia: A critical review of the qualitative literature. Dementia, 15(6), 1534–1561. https://doi.org/10.1177/1471301214564792
Lüdecke, D., von dem Knesebeck, O., & Kofahl, C. (2016). Public knowledge about dementia in Germany—results of a population survey. International Journal of Public Health, 61(1), 9–16. https://doi.org/10.1007/s00038-015-0703-x
Mahmud, S., Begum, M. K., & Akhter, J. (2020). Knowledge and attitude of senior staff nurses regarding geriatrics health care in a tertiary public hospital. Asian Journal of Medical and Biological Research, 6, 431–439.
https://api.semanticscholar.org/CorpusID:228977881
Mamani, A. R. N., Reiners, A. A. O., Azevedo, R. C. de S., Vechia, A. D. R. D., Segri, N. J., & Cardoso, J. D. C. (2019). Elderly caregiver: knowledge, attitudes and practices about falls and its prevention. Revista Brasileira de Enfermagem, 72, 119–126.
https://doi.org/10.1590/0034-7167-2018-0276
Mansouri Arani, M., Aazami, S., Azami, M., & Borji, M. (2017). Assessing attitudes toward elderly among nurses working in the city of Ilam. International Journal of Nursing Sciences, 4(3), 311–313. https://doi.org/10.1016/j.ijnss.2017.06.009
Moon, M. (2017). The Unprepared Caregiver. The Gerontologist, 57(1), 26–31. https://doi.org/10.1093/geront/gnw080
Muhsin, A. A. (2019). KNOWLEDGE LEVEL, ATTITUDES AND THEIR PREDICTORS TOWARDS ELDERLY CARE AMONG NURSING STUDENTS IN ZANZIBAR A CROSS-SECTIONAL STUDY ARAFA ABDULHAKIM MUHSIN MASTER OF SCIENCE IN NURSING EDUCATION. http://hdl.handle.net/20.500.12661/2058
Murman. (2015). The Impact of Age on Cognition. 36(3), 111–121.
https://doi.org/https://doi.org/10.1055/s-0035-1555115
Nandi, A., Counts, N., Chen, S., Seligman, B., Tortorice, D., Vigo, D., & Bloom, D. E. (2022). Global and regional projections of the economic burden of Alzheimer’s disease and related dementias from 2019 to 2050: A value of statistical life approach. EClinicalMedicine, 51, 101580.
https://doi.org/https://doi.org/10.1016/j.eclinm.2022.101580
NILSSON, A., LINDKVIST, M., RASMUSSEN, B. H., & EDVARDSSON, D. (2012). Staff attitudes towards older patients with cognitive impairment: need for improvements in acute care. Journal of Nursing Management, 20(5), 640–647.
https://doi.org/https://doi.org/10.1111/j.1365-2834.2012.01406.x
Ong, M. F., Soh, K. L., Saimon, R., Wai, M. W., Mortell, M., & Soh, K. G. (2021). Fall prevention education to reduce fall risk among community-dwelling older persons: A systematic review. Journal of Nursing Management, 29(8), 2674–2688.
https://doi.org/10.1111/jonm.13434
Özdemir, Ö., & Bilgili, N. (2016). Attitudes of Turkish Nursing Students Related to Ageism. Journal of Nursing Research, 24(3). https://journals.lww.com/jnr-twna/fulltext/2016/09000/attitudes_of_turkish_nursing_students_related_to.5.aspx
Peach, T., Pollock, K., Van Der Wardt, V., Das Nair, R., Logan, P., & Harwood, R. H. (2017). Attitudes of older people with mild dementia and mild cognitive impairment and their relatives about falls risk and prevention: A qualitative study. PLoS ONE, 12(5). https://doi.org/10.1371/journal.pone.0177530
Perrotta, M. L., Saha, P., Zawadzki, R., Beidelman, M., Ingelsson, E., Lui, G. K., & Priest, J. R. (2020). Adults with mild-to-moderate congenital heart disease demonstrate measurable neurocognitive deficits. Journal of the American Heart Association, 9(19). https://doi.org/10.1161/JAHA.119.015379
Piers, R. D., Versluys, K., Devoghel, J., Vyt, A., & Van Den Noortgate, N. (2019). Interprofessional teamwork, quality of care and turnover intention in geriatric care: A cross-sectional study in 55 acute geriatric units. International Journal of Nursing Studies, 91, 94–100. https://doi.org/https://doi.org/10.1016/j.ijnurstu.2018.11.011
Pitkälä, K. H., Martin, F. C., Maggi, S., Jyväkorpi, S. K., & Strandberg, T. E. (2018). Status of Geriatrics in 22 Countries. The Journal of Nutrition, Health & Aging, 22(5), 627–631. https://doi.org/10.1007/s12603-018-1023-7
Quinn, C., Nelis, S. M., Martyr, A., Victor, C., Morris, R. G., & Clare, L. (2019). Influence of Positive and Negative Dimensions of Dementia Caregiving on Caregiver Well-Being and Satisfaction With Life: Findings From the IDEAL Study. American Journal of Geriatric Psychiatry, 27(8), 838–848. https://doi.org/10.1016/j.jagp.2019.02.005
Reimann, H., Ramadan, R., Fettrow, T., Hafer, J. F., Geyer, H., & Jeka, J. J. (2020). Interactions Between Different Age-Related Factors Affecting Balance Control in Walking. Frontiers in Sports and Active Living, 2. https://doi.org/10.3389/fspor.2020.00094
Rivan, N. F. M., Shahar, S., Rajab, N. F., Singh, D. K. A., Din, N. C., Hazlina, M., & Hamid, T. A. T. A. (2019). Cognitive frailty among Malaysian older adults: Baseline findings from the LRGS TUA cohort study. Clinical Interventions in Aging, 14, 1343–1352. https://doi.org/10.2147/CIA.S211027
Robinson, A. , E. C. , A. M. , E. K. E. , A. S. , S. C. , A. M. , D. C. , B. S. , T. C. , & M. F. (2015). Who knows, who cares? Dementia knowledge among nurses, care workers, and family members of people living with dementia. Journal of Palliative Care, 30(3), 158–165.
Rudnicka, E., Napiera?a, P., Podfigurna, A., M?czekalski, B., Smolarczyk, R., & Grymowicz, M. (2020). The World Health Organization (WHO) approach to healthy ageing. Maturitas, 139, 6–11. https://doi.org/10.1016/j.maturitas.2020.05.018
Rush, K. L., Hickey, S., Epp, S., & Janke, R. (2017). Nurses’ attitudes towards older people care: An integrative review. Journal of Clinical Nursing, 26(23–24), 4105–4116. https://doi.org/https://doi.org/10.1111/jocn.13939
Sallim, A. Bin, Sayampanathan, A. A., Cuttilan, A., & Chun-Man Ho, R. (2015). Prevalence of Mental Health Disorders Among Caregivers of Patients With Alzheimer Disease. Journal of the American Medical Directors Association, 16(12), 1034–1041. https://doi.org/10.1016/j.jamda.2015.09.007
Scott, C. B., Clay, O. J., Epps, F., Cothran, F. A., & Williams, I. C. (2018). Associations of knowledge of Alzheimer’s disease and memory loss and employment status with burden in African American and Caucasian family caregivers. Dementia, 19(3), 847–860. https://doi.org/10.1177/1471301218788147
Semiatin, A. M. , & O. M. K. (2012). The relationship between self-efficacy and positive aspects of caregiving in Alzheimer’s disease caregivers. Aging & Mental Health, 16(6), 683–688. https://doi.org/10.1080/13607863.2011.651437
Shaw, F. E. (2007). Prevention of falls in older people with dementia. Journal of Neural Transmission, 114(10), 1259–1264. https://doi.org/10.1007/s00702-007-0741-5
Singh, D. K. A., Goh, J. W., Shaharudin, M. I., & Shahar, S. (2021). A Mobile App (FallSA) to identify fall risk among Malaysian community-dwelling older persons: Development and validation study. JMIR MHealth and UHealth, 9(10). https://doi.org/10.2196/23663
Song, Y., Anderson, R. A., Corazzini, K. N., & Wu, B. (2014). Staff characteristics and care in Chinese nursing homes: A systematic literature review. International Journal of Nursing Sciences, 1(4), 423–436. https://doi.org/https://doi.org/10.1016/j.ijnss.2014.10.003
Sultana, M., Alexander, N., Pierucini-Faria, F., Hunter, S. W., Kamkar, N., Speechley, M. R., Son, S., Verghese, J., & Montero-Odasso, M. (2023). Involvement of ICG in Preventing Falls in Older Adults with Cognitive Impairment: A Rapid Review. Journal of Alzheimer’s Disease, 92, 741–750. https://doi.org/10.3233/JAD-221142
Sun, R., Cao, H., Zhu, X., Liu, J.-P., & Dong, E. (n.d.). REVIEW Current aging research in China. Protein & Cell. https://doi.org/10.1007/s13238-015-0145-5
Sun, X., Nugraha, S., Hu, Y., Min, R., Dong, X., Liu, G., & Yin, X. (n.d.). Fall risks and the related factors for the homebound older people with dementia: Evidence from East China.
Teichmann, B., Gkioka, M., Kruse, A., & Tsolaki, M. (2022). ICG’ Attitude Toward Dementia: The Impact of Dementia Knowledge, Confidence in Dementia Care, and the Behavioral and Psychological Symptoms of the Person with Dementia. A Cross-Sectional Study. Journal of Alzheimer’s Disease, 88(3), 971–984. https://doi.org/10.3233/JAD-215731
Towle, R. M., Tan, C. G., Saptu, K., Ong, L. J., Yap, M. M., Kheng, J. H., & Low, L. L. (2019). What do caregivers value and is there agreement in perception of met needs between nurses and caregivers? Singapore Medical Journal, 60(11), 575–582. https://doi.org/10.11622/smedj.2019040
Tsolaki, M., Paraskevi, S., Degleris, N., & Karamavrou, S. (2008). Attitudes and Perceptions Regarding Alzheimer’s Disease in Greece. American Journal of Alzheimer’s Disease & Other Dementias®, 24(1), 21–26. https://doi.org/10.1177/1533317508325990
Tyler, D. A., Jung, H.-Y., Feng, Z., & Mor, V. (2010). Prevalence of Nursing Assistant Training and Certification Programs Within Nursing Homes, 1997–2007. The Gerontologist, 50(4), 550–555. https://doi.org/10.1093/geront/gnq014
Yu, D. S. F., Cheng, S.-T., & Wang, J. (2018). Unravelling positive aspects of caregiving in dementia: An integrative review of research literature. International Journal of Nursing Studies, 79, 1–26. https://doi.org/https://doi.org/10.1016/j.ijnurstu.2017.10.008
Yuan, Q., Tan, G. T. H., Wang, P., Devi, F., Goveas, R., Magadi, H., Ng, L. L., Chong, S. A., & Subramaniam, M. (2021). Combining a variable?centered and a person-centered analytical approach to caregiving burden – a holistic approach. BMC Geriatrics, 21(1). https://doi.org/10.1186/s12877-021-02238-2
Zawadzki, L., Mondon, K., Peru, N., Hommet, C., Constans, T., Gaillard, Ph., & Camus, V. (2011). Attitudes towards Alzheimer’s disease as a risk factor for caregiver burden. International Psychogeriatrics, 23(9), 1451–1461. https://doi.org/DOI:
10.1017/S1041610211000640
Zawadzki, M. J., Small, A. K., & Mausbach, B. T. (2022). An upward cycle: examining bidirectional relationships between everyday activities and momentary affective well-being in caregivers. The Journal of Positive Psychology, 17(6), 847–857. https://doi.org/10.1080/17439760.2021.1952646
Zenker, R., Pardell, C., Gilmore-Bykovskyi, A., Kind, A., & Werner, N. (2017). Exploring Workload among ICG of Persons with Dementia. Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 61, 1297.
https://doi.org/10.1177/1541931213601805
Zhang, L. ling, Dalal, K., Yin, M. min, Yuan, D. guo, Andrews, J. Y., & Wang, S. mei. (2012). The KAP evaluation of intervention on fall-induced injuries among elders in a safe community in Shanghai, China. PLoS ONE, 7(3).
https://doi.org/10.1371/journal.pone.0032848
Zhou, Y., Strayer, A. T., Phelan, E. A., Sadak, T., & Hooyman, N. R. (2021). A mixed methods systematic review of ICG’ experiences of fall risk among community-dwelling elders with dementia. In Health and Social Care in the Community (Vol. 29, Issue 4, pp. 1126–1144). Blackwell Publishing Ltd. https://doi.org/10.1111/hsc.13148
