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Falls Incidence, Risk Factors, and Consequences in Chinese Older People: A Systematic Review

Authors

  • Marcella Mun-San Kwan MPH,

    1. From the *Falls and Balance Research Group, Neuroscience Research Australia, School of Public Health and Community Medicine, and Prince of Wales Clinical School, University of New South Wales, Randwick, Sydney, Australia.
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  • Jacqueline C.T. Close MD,

    1. From the *Falls and Balance Research Group, Neuroscience Research Australia, School of Public Health and Community Medicine, and Prince of Wales Clinical School, University of New South Wales, Randwick, Sydney, Australia.
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  • Alfred Kwok Wai Wong MBBS,

    1. From the *Falls and Balance Research Group, Neuroscience Research Australia, School of Public Health and Community Medicine, and Prince of Wales Clinical School, University of New South Wales, Randwick, Sydney, Australia.
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  • Stephen R. Lord DSc

    1. From the *Falls and Balance Research Group, Neuroscience Research Australia, School of Public Health and Community Medicine, and Prince of Wales Clinical School, University of New South Wales, Randwick, Sydney, Australia.
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Address correspondence to Professor Stephen Lord, Neuroscience Research Australia, Barker Street, Randwick, NSW, 2031, Australia. E-mail: s.lord@neura.edu.au

Abstract

Falls incidence in Chinese older people has been reported to be approximately half that of Caucasian populations. It is possible that the falls risk factor profile may differ significantly between Caucasian and Chinese populations, and a better understanding of this reported difference in incidence and associated risk factors may influence potential approaches to future intervention. A systematic literature review was conducted using the EMBase, Medline, Chinese Electronic Periodical Services, and WanFangdata databases to collate and evaluate the studies that have addressed the incidence and risk factors for falls in Chinese older people. Twenty-one studies conducted in China, Hong Kong, Macao, Singapore, and Taiwan met the inclusion criteria. Fall rates ranged between 14.7% and 34% per annum (median 18%). In the four prospective studies, injuries were reported by 60% to 75% of those reporting falls, with fractures constituting 6% to 8% of all injuries. One hundred thirty-two variables were identified as fall risk factors, with commonly reported factors being female sex, older age, use of multiple medications, gait instability, fear of falling, and decline in activities of daily living. The findings reveal a consistently lower incidence of self-reported falls in Chinese older people than in Caucasian older people, although the types and prevalence of risk factors were not dissimilar from those found in studies of Caucasian older people. A greater understanding of the health, behavioral, and lifestyle factors that influence fall rates in Chinese populations is required for elucidating fall prevention strategies in Chinese and non-Chinese older people.

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