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.
Keywords
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Article info
Publication history
Published online: August 05, 2015
Footnotes
The author declares no conflicts of interest.
Identification
Copyright
© 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
