Episodes of falling among elderly people: a systematic review and meta-analysis of social and demographic pre-disposing characteristics

Abstract

CONTEXT:The multifactorial nature of falls among elderly people is well-known. Identifying the social-demographic characteristics of elderly people who fall would enable us to define the typical profile of the elderly who are at risk of falling.OBJECTIVE:We aimed to isolate studies in which the social-demographic risk factors for falls among the elderly have been evaluated and to carry out a meta-analysis by combining the results of all of these selected studies.METHOD:We did a systematic literature review using the key words "accidental fall / numerical data" and "risk factors.” Inclusion criteria entailed the selection of articles with the following characteristics: population of subjects aged 60 years or over, falls that took place in everyday life, and social-demographic risk factors for falls.RESULTS:3,747 indexed articles published between 1981 and 2007 were identified, and 177 studies with available data were included, of which 129 had data on social-demographic risk factors for falls. Difficulties in activities of daily living (ADL) or in instrumental activities of daily living (IADL) double the risk of falling: The OR and 95% Cl were 2.26 (2.09, 2.45) for disturbance ADL and 2.10 (1.68, 2.64) for IADL. The OR and 95% Cl for Caucasians were 1.68 (0.98 - 2.88) and 0.64 (0.51 - 0.80) for Hispanics. In the subgroup of patients older than eighty, being married protected people from falling with an OR and 95% Cl = 0.68 (0.53 - 0.87).CONCLUSION:Defining factors that create a risk of falling and protect elderly people from falls using social-demographic characteristics lets us focus on an “at risk” population for which a specific program could be developed.

Predicting falls in elderly patients with chronic pain and other chronic conditions

“…Dependency in daily activities has previously been reported to be strongly associated with falling [21][22][23]. Other studies found pain-related interference with daily activities to be associated with falls, even after adjustment for several confounders [1,24].…”

Impact of physical activity and sedentary behaviour on fall risks in older people: a systematic review and meta-analysis of observational studies

“…Meta-analyses on drugs [19][20][21][22][23], muscle weakness [24], balance impairment [25], sociodemographic items [26] and fall risk in older persons have all been carried out. That said, the only meta-analysis performed on exercises aimed at preventing falls is quite recent and dealt only with randomised controlled trials (RCTs) [27].…”

Assessment and management of falls in older people

“…A systematic review of randomized controlled trials and observational studies showed that the presence of any difficulties with ADLs was associated with an increased risk of falling (for ADLs, OR 2.26, 95% CI 2.09-2.45; for instrumental ADLs, OR 2.10, 95% CI 1.68-2.64). 14 The social history should address the patient's living conditions, including various environment al factors and hazards, both indoors and outdoors, such as rugs, bathroom equipment, lighting, bath rails, clutter, wet surfaces, gait aids, assistive devices, weather conditions and footwear. One systematic review of cohort and cross-sectional studies showed an increased risk of falls in the presence of mobility aids in both the community (OR 2.07, 95% CI 1.59-2.71) and institutional settings such as retirement homes and long-term care facilities (OR 1.77, 95% CI 1.66-1.89).…”