Risk factors for falls in older people in nursing homes and hospitals. A systematic review and meta-analysis

Silvia Deandrea, Francesca Bravi, Federica Turati, Ersilia Lucenteforte, Carlo La Vecchia, Eva Negri

Research output: Contribution to journalArticle

Abstract

This is a systematic review and meta-analysis aimed at providing a comprehensive and quantitative review of risk factors for falls in older people in nursing homes and hospitals. Using MEDLINE, we searched for prospective studies investigating risk factors for falls in nursing home residents (NHR) and older hospital inpatients (HI). When there were at least 3 studies investigating a factor in a comparable way in a specific setting, we computed the pooled odds ratio (OR) using random effect models. Twenty-four studies met the inclusion criteria. Eighteen risk factors for NHR and six for HI were considered, including socio-demographic, mobility, sensory, medical factors, and medication use. For NHR, the strongest associations were with history of falls (OR = 3.06), walking aid use (OR = 2.08) and moderate disability (OR = 2.08). For HI, the strongest association was found for history of falls (OR = 2.85). No association emerged with age in NHR (OR = 1.00), while the OR for a 5. years increase in age of HI was 1.04. Female sex was, if anything, associated with a decreased risk. A few other medical conditions and medications were also associated with a moderately increased risk. For some important factors (e.g. balance and muscle weakness), a summary estimate was not computed because the measures used in various studies were not comparable. Falls in older people in nursing homes and hospitals have multifactorial etiology. History of falls, use of walking aids and disability are strong predictors of future falls.

Original languageEnglish
Pages (from-to)407-415
Number of pages9
JournalArchives of Gerontology and Geriatrics
Volume56
Issue number3
DOIs
Publication statusPublished - May 2013

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nursing home
Nursing Homes
Meta-Analysis
Odds Ratio
Inpatients
resident
medication
Walking
history
disability
medical factors
etiology
Muscle Weakness
MEDLINE
inclusion
Demography
Prospective Studies

Keywords

  • Accidental falls
  • Aged
  • Hospitals
  • Nursing homes
  • Risk factors

ASJC Scopus subject areas

  • Ageing
  • Geriatrics and Gerontology
  • Health(social science)
  • Gerontology

Cite this

Risk factors for falls in older people in nursing homes and hospitals. A systematic review and meta-analysis. / Deandrea, Silvia; Bravi, Francesca; Turati, Federica; Lucenteforte, Ersilia; La Vecchia, Carlo; Negri, Eva.

In: Archives of Gerontology and Geriatrics, Vol. 56, No. 3, 05.2013, p. 407-415.

Research output: Contribution to journalArticle

Deandrea, Silvia ; Bravi, Francesca ; Turati, Federica ; Lucenteforte, Ersilia ; La Vecchia, Carlo ; Negri, Eva. / Risk factors for falls in older people in nursing homes and hospitals. A systematic review and meta-analysis. In: Archives of Gerontology and Geriatrics. 2013 ; Vol. 56, No. 3. pp. 407-415.
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