The physical environment as a fall risk factor in older adults: Systematic review and meta-analysis of cross-sectional and cohort studies.
OBJECTIVE
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.


METHODS
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.
Letts
Lori
L
School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada. lettsl@mcmaster.ca
Moreland
Julie
J
Richardson
Julie
J
Coman
Liliana
L
Edwards
Mary
M
Ginis
Kathleen Martin
KM
Wilkins
Seanne
S
Wishart
Laurie
L
D000058:Accidental Falls; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004779:Environment Design; D006801:Humans; D012111:Residence Characteristics