Prevalence of adherence to antihypertensive treatment: a comparison of drug biochemical analysis and the self-report scale.

Falls represent a leading cause of injury-related morbidity and mortality among older adults (), with particularly devastating consequences for individuals with cognitive impairment. Older adults with mild cognitive impairment (MCI) or dementia experience fall rates approximately twice those of cognitively intact peers (), and the sequelae of falls in this population — including hip fractures, traumatic brain injuries, prolonged hospitalization, and accelerated cognitive and functional decline — are substantially more severe (). With the global prevalence of dementia projected to rise from an estimated 57 million cases in 2019 to over 150 million by 2050 (), the burden of fall-related harm in cognitively impaired populations poses an escalating challenge to healthcare systems worldwide (). Exercise-based interventions have emerged as a cornerstone strategy for fall prevention in older adults (). Various exercise modalities have been investigated, including aerobic exercise, resistance training, balance training, mind-body exercise (e.g., Tai Chi, yoga, Baduanjin), multicomponent exercise programs, dual-task training, and exergaming (). Clinical guidelines recommend exercise as a first-line non-pharmacological intervention for fall prevention (). However, the optimal exercise modality for cognitively impaired populations remains uncertain, as the mechanisms underlying fall risk in these individuals—such as impaired executive function, attentional deficits, and reduced dual-task capacity — may differ from those in cognitively intact older adults (). Several specific gaps in the current evidence base motivate the present review. First, existing systematic reviews on exercise and falls in cognitively impaired populations (, ) have relied exclusively on pairwise meta-analyses, which compare only two interventions at a time and cannot generate a unified ranking of all available exercise options. Second, the most comprehensive network meta-analyses of exercise for fall prevention, such as the Cochrane review by Sherrington et al. (), have focused on the general older adult population without examining the cognitively impaired subgroup, and no existing NMA has simultaneously compared the full spectrum of exercise modalities — including emerging approaches such as dual-task training and exergaming — for fall prevention specifically in adults with MCI or dementia (). Third, previous reviews in this population have predominantly examined balance or cognitive outcomes without prioritizing fall-specific endpoints as co-primary outcomes (). Consequently, clinicians lack definitive guidance on which exercise modality to prescribe for fall prevention in this high-risk population.