Racial and Ethnic Differences in Falls Among Older Adults: a Systematic Review and Meta-analysis

Abstract

The aim of this systematic review and meta-analysis was to determine whether differences in reported fall rates exist between different ethnic groups. Searches were carried out on four databases: Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Web of Science. Only English language studies with community-dwelling participants aged 60 + years were included. Studies also needed to compare fall prevalence for at least two or more ethnic groups. Two reviewers independently screened all articles and evaluated study quality. Twenty-three articles were included for systematic review, and meta-analyses were carried out on the 16 retrospective studies that reported falls in the previous 12 months. The Asian group demonstrated significantly lower fall prevalence than all other ethnic groups at 13.89% (10.87, 16.91). The Hispanic group had a fall prevalence of 18.54% (12.95, 24.13), closely followed by the Black group at 18.60% (13.27, 23.93). The White group had the highest prevalence at 23.77% (18.66, 28.88). Some studies provided adjusted estimates of effect statistics for the odds/risk of falls, which showed that differences still existed between some ethnic groups even after adjusting for other risk factors. Overall, differences in fall prevalence do appear to exist between different ethnic groups, although the reasons for these differences currently remain undetermined and require further investigation. These findings highlight the need to provide more ethnically tailored responses to public health challenges, which could potentially increase the adherence to prevention interventions, and allow for a more targeted use of resources.

Development and external validation of a risk prediction model for falls in patients with an indication for antihypertensive treatment: retrospective cohort study

“…We identified clinically relevant predictors of falls from the literature and through expert clinical opinion. 2 7 8 9 23 These included 30 predictors (44 predictor variables), covering patient demographics (age, sex, ethnicity, area based socioeconomic deprivation (index of multiple deprivation), body mass index (BMI), systolic and diastolic blood pressure), clinical characteristics (total cholesterol level, smoking status, alcohol intake), comorbidities (previous falls, memory problems, mobility issues, history of stroke, multiple sclerosis, activity limitation, syncope, cataract), and prescribed drugs (antihypertensives, opioids, hypnotics or benzodiazepines, antidepressants, anticholinergics) (see table S4.2 in the supplementary material). A recent literature review of falls clinical prediction tools by the National Institute for Health and Care Excellence identified the need for frailty to be considered as a predictor in models for use in the community.…”

Age and Gender Differences in Fall-Related Factors Affecting Community-Dwelling Older Adults

“…Racial differences may also contribute to differences in fall prevalence. In a previous study, older Asian adults were reported to be less likely to fall than older adults in other ethnic groups (Wehner-Hewson et al, 2022). Similar to the findings in this study, the prevalence of multiple falls was found to be 6.7% among Chinese older adults in another study, with multiple falls further found to be associated with physical frailty ( OR = 6.79; Ma et al, 2021).…”

Effect of number of medications on the risk of falls among community‐dwelling older adults: A 3‐year follow‐up of the SONIC study

“…Falls are common among older people, with approximately 14%-30% of people living in communities experiencing falls. 1,2 Moreover, approximately half of those who experience falls experience more than one fall. 3 Falls in older adults can cause injuries such as fractures, dislocations, cuts, and bruises.…”