Estimation of the risk factors for falls in the elderly: Can meta‐analysis provide a valid answer?

Abstract

The objective of this study was to analyze whether a meta-analysis could allow us to draw useful conclusions about the risk factors for falls in the elderly. A systematic review was carried out of various databases and completed manually. To satisfy the inclusion criteria, an article had to examine a population of subjects aged over 60 years to pertain to falls occurring during daily living activities, and to involve observational or interventional studies. This review identified 4405 indexed articles published between 1981 and 2011. Of the 220 studies with available data that were included in the final study, just 4% were interventional. Among these 220 studies, just 45% offered a satisfactory level of scientific proof. In total, 88 meta-analyses were carried out on the 156 potential protectors or risk factors that were identified. Our systematic review and meta-analyses ensured that high-quality results were obtained from this comprehensive literature search and included a detailed assessment of the quality of the included studies. Several factors appeared to be disproportionately represented in the literature, a fact that likely reflects the objective and precise assessment of these factors rather than their importance in the falls of the elderly. Thus, we cannot be certain that we obtained the most comprehensive analysis of the risk factors for falling with this method. Meta-analyses can help to define the association between falls and various risk factors, but they have to be used complementary to systematic review for the assessment of risk factors.

Ginkgo biloba special extract LI 1370 improves dual-task walking in patients with MCI: a randomised, double-blind, placebo-controlled exploratory study

“…In the current study, base of support increased in the IG and CG in all conditions. Previous research discussed such gait pattern adaptations as indicative for precautious gait [50] and fear of falling, an important fall risk factor [51]. Base of support values were comparable to previous studies in similar populations (between 7.9 and 10.7 cm) [46, 52].…”

Gait disturbances as specific predictive markers of the first fall onset in elderly people: a two-year prospective observational study

“…In this respect, it is not necessarily surprising that no difference between the four groups was found when considering all the screened clinical variables (see Table 3). It might be suggested that the present population was “full-matched” at the time of inclusion, with the same well-documented multifactorial risks for falling (Gillespie et al, 2012; Bloch et al, 2013). Thus our current findings on the specific gait markers reinforce the main idea to accurately assess gait behavior for this healthy home-dwelling population.…”

“…According to the main factors identified involved in the risk of falling in older people (Gillespie et al, 2012; Bloch et al, 2013), the relationship between falls and these potential confounding factors was examined by means of multinomial logistic regression analysis. By performing this statistical analysis for each variable separately, we specified the association between (the risk of) the first fall and these clinical factors, with the non-fallers group used as the reference level.…”

“…According to significant meta-analyses (Gillespie et al, 2012; Bloch et al, 2013), among the most important intrinsic predictors of falls are taking medications [Odds Ratio = 4.24 (3.06–5.88) 95% Confidence interval), abnormal balance test [ OR = 2.26 (1.79–2.85)], low body mass index [ OR = 2.05 (1.70–2.48)], fracture history [ OR = 1.89 (1.53–2.34)], vision impairment [ OR = 1.49 (1.39–1.59)], cardiac rhythm disorder [ OR = 1.42 (1.14–1.75)], impaired cognition [ OR = 1.96 (1.80–2.14)], or limited activity [ OR = 1.32 (1.01–1.72)].…”

Aides à la marche à un âge avancé: tout est sous contrôle?

“…C'est pourquoi il semble paradoxal que des études scientifiques démontrent que l'utilisation d'une aide à la marche conduit à un nombre de chutes multiplié par deux chez les personnes âgées [6]. Par exemple, lorsque l'aide à la marche devient une entrave dans une situation de stress ou que l'application de la technique adéquate demande trop d'énergie, l'aide à la marche peut devenir un obstacle et augmenter le risque de chute.…”