Global prevalence of falls in the older adults: a comprehensive systematic review and meta-analysis

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Abstract

Background

With increasing life expectancy, declining mortality, and birth rates, the world's geriatric population is increasing. Falls in the older people are one of the most common and serious problems. Injuries from falls can be fatal or non-fatal and physical or psychological, leading to a reduction in the ability to perform activities of daily living. The aim of this study was to determine the prevalence of falls in the older people through systematic review and meta-analysis.

Methods

In this systematic review and meta-analysis, the data from studies on the prevalence of falls in the older people in the world were extracted in the databases of Scopus, Web of Science (WoS), PubMed and Science Direct, and Google Scholar, Magiran and Scientific Information Database (SID) without any time limit until August 2020. To analyze the eligible studies, the stochastic effects model was used, and the heterogeneity of the studies with the I ² index was investigated. Data analysis was conducted with Comprehensive Meta-Analysis software (Version 2).

Results

In the review of 104 studies with a total sample size of 36,740,590, the prevalence of falls in the older people of the world was 26.5% (95% CI 23.4–29.8%). The highest rate of prevalence of falls in the older people was related to Oceania with 34.4% (95% CI 29.2–40%) and America with 27.9% (95% CI 22.4–34.2%). The results of meta-regression indicated a decreasing trend in the prevalence of falls in the older people of the world by increasing the sample size and increasing the research year ( P < 0.05).

Conclusion

The problem of falls, as a common problem with harmful consequences, needs to be seriously considered by policymakers and health care providers to make appropriate plans for preventive interventions to reduce the rate of falls in the older people.

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Most cited references 107

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Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention.

Susan M. Friedman, Beatriz Adelaida Muñoz, Sheila K. West … (2002)

Previous cross-sectional studies have shown a correlation between falls and fear of falling, but it is unclear which comes first. Our objectives were to determine the temporal relationship between falls and fear of falling, and to see whether these two outcomes share predictors. A 20-month, population-based, prospective, observational study. Salisbury, Maryland. Each evaluation consisted of a home-administered questionnaire, followed by a 4- to 5-hour clinic evaluation. The 2,212 participants in the Salisbury Eye Evaluation project who had baseline and 20-month follow-up clinic evaluations. At baseline, subjects were aged 65 to 84 and community dwelling and had a Mini-Mental State Examination score of 18 or higher. Demographics, visual function, comorbidities, neuropsychiatric status, medication use, and physical performance-based measures were assessed. Stepwise logistic regression analyses were performed to evaluate independent predictors of falls and fear of falling at the follow-up evaluation, first predicting incident outcomes and then predicting fall or fear-of-falling status at 20 months with baseline falling and fear of falling as predictors. Falls at baseline were an independent predictor of developing fear of falling 20 months later (odds ratio (OR) = 1.75; P <.0005), and fear of falling at baseline was a predictor of falling at 20 months (OR = 1.79; P <.0005). Women with a history of stroke were at risk of falls and fear of falling at follow-up. In addition, Parkinson's disease, comorbidity, and white race predicted falls, whereas General Health Questionnaire score, age, and taking four or more medications predicted fear of falling. Individuals who develop one of these outcomes are at risk for developing the other, with a resulting spiraling risk of falls, fear of falling, and functional decline. Because falls and fear of falling share predictors, individuals who are at a high risk of developing these endpoints can be identified.

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Falls by elderly people at home: prevalence and associated factors.

A. J. BLAKE, K. Morgan, M. BENDALL … (1988)

Of 1042 individuals aged 65 years and over who were successfully interviewed in a community survey of health and physical activity, 35% (n = 356) reported one or more falls in the preceding year. Although the overall ratio of female fallers to male fallers was 2.7:1, this ratio approached unity with advancing age. Mobility was significantly impaired in those reporting falls. Asked to provide a reason for their falls, 53% reported tripping, 8% dizziness and 6% reported blackouts. A further 19% were unable to give a reason. There was no association between falls and the use of diuretics, antihypertensives or tranquilizers, but a significant association between falls and the use of hypnotics and antidepressants was found. Discriminant analysis of selected medical and anthropometric variables indicated that handgrip strength in the dominant hand and reported symptoms of arthritis, giddiness and foot difficulties were most influential in predicting reports of recent falls.

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Circumstances and consequences of falls in independent community-dwelling older adults.

W Berg, H Alessio, E Mills … (1997)

knowledge of the circumstances and consequences of falls in older adults is important for understanding the aetiology of falls as well as for effective clinical assessment and design of fall prevention strategies. Such data, however, are relatively scarce, especially in community-dwelling elders. accidental falls (including their circumstances and consequences) occurring in 96 male and female participants between 60 and 88 years of age were monitored prospectively for 1 year. After the monitoring period, participants were divided into three groups based on fall status: non-fallers (n = 46), one-time fallers (n = 27) and recurrent fallers (n = 23). Frequency distributions were created for selected circumstances and consequences of falls and the prevalence of these consequences were examined. 50 participants (52%) fell during the 1 year period, amassing 91 falls. Trips and slips were the most prevalent causes of falls, accounting for 59% of falls. Falls most often occurred during the afternoon and while subjects walked on level or uneven surfaces. Fallers most commonly attributed falls to hurrying too much. Fractures resulted from five of the 91 falls and eight other falls resulted in soft tissue injuries that required treatment by a physician. There were no differences between one-time and recurrent fallers in the circumstances and consequences of falls. However, several notable differences were found between men (n = 20) and women (n = 30) who fell. Falls by men most often resulted from slips whereas falls by women most often resulted from trips. Moreover, women and men differed in the time of the year in which falls occurred, with men falling most often during winter and women during summer. the results of this study provide insight into the circumstances and consequences of falls among independent community-dwelling older adults and suggest some possible ways of preventing falls. Preventive services, however, should not solely target recurrent fallers, nor should the type of services necessarily differ for one-time and recurrent fallers.

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Author and article information

Contributors

Nader Salari: n_s_54@yahoo.com

Niloofar Darvishi: darvishinilofar@gmail.com

Melika Ahmadipanah: miss.sbu78@gmail.com

Shamarina Shohaimi: shamarna@upm.edu.my

Masoud Mohammadi:

ORCID: http://orcid.org/0000-0002-5722-8300

Masoud.mohammadi1989@yahoo.com

Journal

Journal ID (nlm-ta): J Orthop Surg Res

Journal ID (iso-abbrev): J Orthop Surg Res

Title: Journal of Orthopaedic Surgery and Research

Publisher: BioMed Central (London )

ISSN (Electronic): 1749-799X

Publication date (Electronic): 28 June 2022

Publication date PMC-release: 28 June 2022

Publication date Collection: 2022

Volume: 17

Electronic Location Identifier: 334

Affiliations

[1 ]GRID grid.412112.5, ISNI 0000 0001 2012 5829, Department of Biostatistics, School of Health, , Kermanshah University of Medical Sciences, ; Kermanshah, Iran

[2 ]GRID grid.412112.5, ISNI 0000 0001 2012 5829, Student Research Committee, , Kermanshah University of Medical Sciences, ; Kermanshah, Iran

[3 ]GRID grid.411600.2, Student Research Committee, , Shahid Beheshti University of Medical Sciences, ; Tehran, Iran

[4 ]GRID grid.11142.37, ISNI 0000 0001 2231 800X, Department of Biology, Faculty of Science, , University Putra Malaysia, ; Serdang, Selangor Malaysia

[5 ]GRID grid.512375.7, ISNI 0000 0004 4907 1301, Cellular and Molecular Research Center, , Gerash University of Medical Sciences, ; Gerash, Iran

Author information

Masoud Mohammadi http://orcid.org/0000-0002-5722-8300

Article

Publisher ID: 3222

DOI: 10.1186/s13018-022-03222-1

PMC ID: 9238111

PubMed ID: 35765037

SO-VID: 8a01f4ad-24f4-48d2-8fa0-6be30eceff9f

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 14 October 2021

Date accepted : 21 June 2022

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100012286, Deputy for Research and Technology, Kermanshah University of Medical Sciences;

Award ID: 3010987

Award Recipient : Masoud Mohammadi

Custom metadata

ScienceOpen disciplines: Surgery

Keywords: fall,prevalence,accident,systematic review,meta-analysis

Data availability:

ScienceOpen disciplines: Surgery

Keywords: fall, prevalence, accident, systematic review, meta-analysis

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Global prevalence of falls in the older adults: a comprehensive systematic review and meta-analysis

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Most cited references 107

Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention.

Falls by elderly people at home: prevalence and associated factors.

Circumstances and consequences of falls in independent community-dwelling older adults.

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Cited by 23

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