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The physical environment as a fall risk factor in older adults: Systematic review and meta‐analysis of cross‐sectional and cohort studies
Author(s) -
Letts Lori,
Moreland Julie,
Richardson Julie,
Coman Liliana,
Edwards Mary,
Ginis Kathleen Martin,
Wilkins Seanne,
Wishart Laurie
Publication year - 2010
Publication title -
australian occupational therapy journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.595
H-Index - 44
eISSN - 1440-1630
pISSN - 0045-0766
DOI - 10.1111/j.1440-1630.2009.00787.x
Subject(s) - medicine , odds ratio , cohort , cohort study , risk factor , cross sectional study , confidence interval , gerontology , falls in older adults , poison control , demography , environmental health , injury prevention , pathology , sociology
Background/aim: Evidence that the physical environment is a fall risk factor in older adults is inconsistent. The study evaluated and summarised evidence of the physical environment as a fall risk factor.Methods: Eight databases (1985–2006) were searched. Investigators evaluated quality of two categories (cross‐sectional and cohort) of studies, extracted and analysed data.Results: Cross‐sectional: falls occur in a variety of environments; gait aids were present in approximately 30% of falls.Cohort: Home hazards increased fall risk (odds ratio (OR) = 1.15; 95% confidence interval (CI): 0.97–1.36) although not significantly. When only the high quality studies were included, the OR = 1.38 (95% CI: 1.03–1.87), which was statistically significant. Use of mobility aids significantly increased fall risk in community (OR = 2.07; 95% CI: 1.59–2.71) and institutional (OR = 1.77; 95% CI: 1.66–1.89) settings.Conclusions: Home hazards appear to be a significant risk factor in older community‐dwelling adults, although they may present the greatest risk for persons who fall repeatedly. Future research should examine relationships between mobility impairments, use of mobility aids and falls.