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The physical environment as a fall risk factor in older adults: Systematic review and meta-analysis of
Lori Letts1, Julie Moreland, Julie Richardson
1School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada. lettsl@mcmaster.ca
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.
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