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Published on: October 25, 2024
Factors Associated With Fall-Related Head Impact Among Older Adults: A Scoping Review
Lingjun Chen1, Tobia Zanotto2, James R Fang3
1Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, USA; Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Objectives:
To map and synthesize the extent, range, and nature of existing research concerning factors associated with fall-related head impact among older adults.
Design:
Scoping review.
Setting And Participants:
Older adults aged 60 years and older.
Methods:
A comprehensive search across 4 databases (PubMed, Web of Science, CINAHL, and Embase) was conducted to identify peer-reviewed research reporting factors associated with head impact during falls. Two reviewers independently screened titles/abstracts and full texts. Data were extracted by 1 reviewer and verified by another, and results were synthesized into 3 domains: individual-, environmental/situational-, and task-level factors.
Results:
Thirteen of 2921 studies met the inclusion/exclusion criteria and were included. Most applied observational analyses of video-recorded falls in long-term care settings, with only 1 interventional study. Female sex, forward-initiated, and forward-landing falls were consistently linked to higher odds of head impact. Findings for age and other individual factors were mixed or insignificant. There was limited evidence that fall timing, activity (eg, walking), and object contact were associated with impact risk. Movement patterns during fall descent (body rotation away from the initial direction and upper limb movements) were associated with lower odds of head impact. One randomized controlled trial reported that older adults could learn protective movements and reduce the odds of head impact during experimentally induced falls.
Conclusions And Implications:
Most factors associated with fall-related head impact were nonmodifiable (eg, sex). Training the use of protective fall movements, environmental design (including protective equipment), and education hold promise in reducing the risk of head impact. Future research should prioritize testing modifiable approaches in real-world settings for reducing fall-related head impact and, ultimately, preventing head injuries in the aging population.
