title: Frailty as a Predictor of Future Falls Among Community-Dwelling Older People: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  Although multiple longitudinal studies have investigated frailty as a predictor of future falls, the results were mixed. Thus far, no systematic review or meta-analysis on this topic has been conducted.
  
  
  OBJECTIVE
  To review the evidence of frailty as a predictor of future falls among community-dwelling older people.
  
  
  METHODS
  Systematic review of literature and meta-analysis were performed using 6 electronic databases (Embase, Scopus, MEDLINE, CINAHL Plus, PsycINFO, and the Cochrane Library) searching for studies that prospectively examined risk of future fall risk according to frailty among community-dwelling older people published from 2010 to April 2015 with no language restrictions.
  
  
  RESULTS
  Of 2245 studies identified through the systematic review, 11 studies incorporating 68,723 individuals were included in the meta-analysis. Among 7 studies reporting odds ratios (ORs), frailty and prefrailty were significantly associated with higher risk of future falls (pooled OR = 1.84, 95% confidence interval [95% CI] = 1.43-2.38, P < .001; pooled OR = 1.25, 95% CI = 1.01-1.53, P = .005, respectively). Among 4 studies reporting hazard ratios (HRs), whereas frailty was significantly associated with higher risk of future falls (pooled HR = 1.24, 95% CI = 1.10-1.41, P < .001), future fall risk according to prefrailty did not reach statistical significance (pooled HR = 1.14, 95% CI = 0.95-1·36, P = .15). High heterogeneity was noted among 7 studies reporting ORs and seemed attributed to difference in gender proportion of cohorts according to subgroup and meta-regression analyses.
  
  
  CONCLUSIONS
  Frailty is demonstrated to be a significant predictor of future falls among community-dwelling older people despite various criteria used to define frailty. The future fall risk according to frailty seemed to be higher in men than in women.
authors.affiliation: Japan Green Medical Centre, London, United Kingdom. Electronic address: gotarokojima@yahoo.co.jp.
authors.forename: Gotaro
authors.initials: G
authors.lastname: Kojima
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005544:Forecasting; D016330:Frail Elderly; D006707:Homes for the Aged; D006801:Humans; D008297:Male
keywords: Frailty; community-dwelling older people; falls