Risk factors for recurrent falls in older adults: A systematic review with meta-analysis

被引:0
作者
Jehu, D. A. [1 ,2 ,3 ]
Davis, J. C. [3 ,4 ]
Falck, R. S. [1 ,2 ,3 ]
Bennett, K. J. [1 ,2 ,3 ]
Tai, D. [1 ,3 ]
Souza, M. F. [1 ,2 ,3 ,5 ]
Cavalcante, B. R. [1 ,2 ,3 ,6 ]
Zhao, M. [1 ,3 ]
Liu-Ambrose, T. [1 ,2 ,3 ]
机构
[1] Univ British Columbia, Dept Phys Therapy, Fac Med, Aging Mobil & Cognit Neurosci Lab, Vancouver, BC, Canada
[2] Vancouver Coastal Hlth Res Inst, Djavad Mowafaghian Ctr Brain Hlth, Vancouver, BC, Canada
[3] Vancouver Coastal Hlth Res Inst, Ctr Hip Hlth & Mobil, Vancouver, BC, Canada
[4] Univ British Columbia Okanagan Campus, Social & Econ Change Lab, Fac Management, Kelowna, BC, Canada
[5] Univ Fed Vale Sao Francisco, UNIVSAF, Dept Phys Educ, Clin Exercise Lab, Petrolina, PE, Brazil
[6] Univ Pernambuco, Associated Grad Program Phys Educ, Recife, PE, Brazil
关键词
Systematic review; Recurrent falls; Risk factors; Older adults; Secondary prevention; ROBUST VARIANCE-ESTIMATION; INJURIOUS FALLS; META-REGRESSION; HIP FRACTURE; FRAILTY; PEOPLE; TRIALS; TESTS; WOMEN;
D O I
10.1016/maturitas.2020.10.021
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Older adults who fall recurrently (i.e., 2 or more falls/year) are at risk of functional decline and mortality. Understanding which risk factors for recurrent falls are most important will inform secondary fall prevention strategies that can reduce recurrent falls risk. Thus, we conducted a systematic review with meta-analysis to determine the relative risk of recurrent falls for different types of falls risk factors. MEDLINE, EMBASE, PsycINFO, and CINAHL databases were searched on April 25, 2019 (Prospero Registration: CRD42019118888). We included peer-reviewed prospective studies which examined risk factors that contributed to recurrent falls in adults aged >= 60 years. Using the falls risk classification system of Lord and colleagues, we classified each risk factor into one of the following domains: 1) balance and mobility; 2) environmental; 3) psychological; 4) medical; 5) medication; 6) sensory and neuromuscular; or 7) sociodemographic. We calculated the summary relative risk (RR) for each domain and evaluated the risk of bias and quality of reporting. Twenty-two studies were included in this systematic review and meta-analysis. Four domains predicted recurrent falls: balance and mobility (RR:1.32;95 % CI:[1.10, 1.59]), medication (RR:1.53;95 % CI:[1.11, 2.10]), psychological (RR:1.35;95 % CI:[1.03, 1.78]), and sensory and neuromuscular (RR:1.51;95 % CI:[1.18, 1.92]). Each of these four domains can be viewed as a marker of frailty. The risk of bias was low, and the study quality was high (minimum:19/22). Older adults with markers of frailty are up to 53 % more likely to experience recurrent falls. Strategies that identify and resolve frailty markers should be a frontline approach to preventing recurrent falls.
引用
收藏
页码:23 / 28
页数:6
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