Lori Letts PhD, OT Reg, (Ont.); Associate Professor. Julie Moreland MSc, BHSc(PT); Associate Clinical Professor, Research Therapist. Julie Richardson PhD, BSc (PT); Associate Professor. Liliana Coman MSc, BHSc (PT); Assistant Professor. Mary Edwards MHSc, BSc(OT), OT Reg. (Ont.); Assistant Professor. Kathleen Martin Ginis PhD; Associate Professor. Seanne Wilkins PhD, OT Reg. (Ont.); Associate Professor. Laurie Wishart PhD, MSc, BSc(PT); Associate Professor.
The physical environment as a fall risk factor in older adults: Systematic review and meta-analysis of cross-sectional and cohort studies
Article first published online: 10 SEP 2009
© 2009 The Authors. Journal compilation © 2009 Australian Association of Occupational Therapists
Australian Occupational Therapy Journal
Volume 57, Issue 1, pages 51–64, February 2010
How to Cite
Letts, L., Moreland, J., Richardson, J., Coman, L., Edwards, M., Ginis, K. M., Wilkins, S. and Wishart, L. (2010), The physical environment as a fall risk factor in older adults: Systematic review and meta-analysis of cross-sectional and cohort studies. Australian Occupational Therapy Journal, 57: 51–64. doi: 10.1111/j.1440-1630.2009.00787.x
- Issue published online: 16 FEB 2010
- Article first published online: 10 SEP 2009
- Acceped for publication 1 February 2009
- accidental falls;
- home hazards;
Background/aim: 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.
Cohort: 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.