Prevalence and Risk Factors for Falls in Older Adults With Diabetes: A Systematic Review and Meta-Analysis

To investigate the prevalence of falls and to assess risk factors associated with falls in older adults with diabetes.

A systematic review and meta-analysis.

Older adults with diabetes (≥60 years).

The literature search encompassed international (PubMed, Web of Science, Embase, Cochrane Library) and Chinese databases (CNKI, Wanfang, VIP, CBM) using systematic methods. The first search was conducted in June 2024, and the search was updated in May 2025. The 2 researchers independently conducted study selection, quality assessments, and data extraction. The meta-analysis was conducted using Stata 16.0 and RevMan 5.3. Pooled incidence rates and odds ratios for the prevalence of falls in older adults with diabetes, as well as for risk factors examined comparably in at least 2 studies, were calculated using fixed or random-effects models.

The systematic review screened 5699 articles, ultimately analyzing data from 32 studies that included 23,666 older adults with diabetes. The pooled prevalence of falls in older adults with diabetes was 29.5%. This risk factor synthesis pooled data from 20 eligible studies, 15 distinct factors demonstrated statistically significant associations with falling incidents, including age, gender, timed up and go test, handgrip strength, cognitive dysfunction, depression, use of walking aids, gait issues, balance difficulties, weight loss, visual function abnormalities, diabetic retinopathy, hypoglycemia, diabetic peripheral neuropathy, and sleep quality.

Older adults with diabetes present a higher risk of falls. Health care providers should screen for factors associated with elevated fall risk and implement early interventions targeting modifiable risk factors to mitigate fall incidents in older adults with diabetes.