Global evidence on falls and subsequent social isolation in older adults: a scoping review

Abstract

BackgroundFalls are a leading cause of injury-related hospitalizations among adults aged 65 years and older and may result in social isolation.ObjectiveTo summarise evidence on falls and subsequent social isolation and/or loneliness in older adults through a scoping review.Eligibility criteriaStudies were eligible for inclusion if the population had a mean age of 60 years or older, they examined falls and subsequent social isolation, loneliness, fear of falling or risk factors and were primary studies (eg, experimental, quasi-experimental, observational and qualitative).Sources of evidenceMEDLINE, CINAHL, Embase, Ageline and grey literature from inception until 11 January 2021.Charting methodsA screening and charting form was developed and pilot-tested. Subsequently, two reviewers screened citations and full-text articles, and charted the evidence.ResultsAfter screening 4993 citations and 304 full-text articles, 39 studies were included in this review. Participants had a history of falling (range: 11% to 100%). Most studies were conducted in Europe (44%) and North America (33%) and were of the cross-sectional study design (66.7%), in the community (79%). Studies utilised 15 different scales. Six studies examined risk factors for social isolation and activity restriction associated with fear of falling. Six studies reported mental health outcomes related to falls and subsequent social isolation.ConclusionsConsistency in outcome measurement is recommended, as multiple outcomes were used across the included studies. Further research is warranted in this area, given the ageing population and the importance of falls and social isolation to the health of older adults.Scoping review registration number10.17605/OSF.IO/2R8HM.

Falls and subsequent cognitive function in older adults in England and the USA, 2010–2020: a population-based, cross-nationally harmonized, longitudinal study

“…[42][43][44] Furthermore, the consequences associated with falls, such as social isolation and activity limitation due to falls, as well as the fear of falling, may further increase the risk of cognitive decline. [10][11][12][13][14]45 Overall, these ndings highlight the signi cance of falls as a potential risk factor for cognitive decline. They emphasize the importance of implementing targeted interventions and strategies to prevent falls and mitigate cognitive decline in individuals who have experienced falls.…”

“…Additionally, fall-related consequences like forced social isolation, diminished physical activity, and the fear of falling can exacerbate the potential risk of cognitive decline. [10][11][12][13][14] However, previous cohort studies that attempted to associate baseline falls with cognitive decline and incident dementia lacked generalizability due to a small sample size 15 and a limited ethnic representation 16 .…”

Relationship between social networks and medication counts: A 1‐year follow‐up pilot study

“…Further investigations of these factors are needed to clarify the relationship between osteoporosis and social isolation, because the study reported mental health outcomes related to falls and subsequent social isolation. 12 In conclusion, social isolation with pain in the lower limbs or osteoporosis treatment might be associated with medication counts. Our results are expected to assist in establishing approaches to improvement in social isolation.…”

Patterns of participation restriction among older adults at risk of falls and relationship with intrinsic capacity: A latent cluster analysis

“…Falls and fear of falling (FOF) amongst older adults are common issues in countries with rapidly aging populations. Up to one-third of older adults ≥65 years fall each year in Canada and the United States, half of whom may experience recurrent falls, and falls accounts for nine in ten of all fractures in older adults (14,15). FOF on the other hand affects between 20 and 85% of older adults, with significant threat to autonomy and participation (16,17).…”

“…FOF on the other hand affects between 20 and 85% of older adults, with significant threat to autonomy and participation (16,17). Both falls and FOF are associated with social isolation, depression, anxiety, poor quality of life, and cognitive impairment, which result in participation restriction that imposes significant burden on the society and healthcare system at large (15,18,19). Risk factors common to both participation restriction, and falls and FOF are older age, low socio-economic status, gender where FOF is more prevalent in females, poor perceived health, frailty, and comorbidities (15,20,21).…”