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. 2020 Aug 28;20(1):808.
doi: 10.1186/s12913-020-05645-0.

Falls prevention interventions for community-dwelling older people living in mainland China: a narrative systematic review

Pengpeng Ye #  1   2 , Yishu Liu #  3   4 , Jing Zhang  5 , Ke Peng  3   6 , Xuru Pan  7 , Yang Shen  4 , Shaoming Xiao  7 , Elizabeth Armstrong  5   8 , Yuliang Er  9 , Leilei Duan  9 , Rebecca Ivers  3   5 , Lisa Keay  3   10 , Maoyi Tian  3   4
Affiliations

Falls prevention interventions for community-dwelling older people living in mainland China: a narrative systematic review

Pengpeng Ye et al. BMC Health Serv Res. .

Abstract

Background: Falls in community-dwelling older people have been recognised as a significant public health issue in China given the rapidly growing aged population. Although there are several reviews documenting falls prevention programs for community-dwelling older adults, no systematic reviews of the scope and quality of falls prevention interventions in Mainland China exist. Therefore, the aim of this study was to systematically review falls prevention interventions for community-dwelling older people living in Mainland China.

Methods: We systematically reviewed literature from Chinese and English databases. All types of randomised controlled trials (RCTs) and quasi-experimental studies published from 1st January 1990 to 30th September 2019 were included. Observational studies and studies in care facilities and hospitals were excluded. Narrative synthesis was performed to summarise the key features of all included studies. Quality assessment was conducted using the Cochrane Risk of Bias Tool and ROBINS-I tool for randomised and non-randomised studies respectively.

Results: A total of 1020 studies were found, and 101 studies were included in the analysis. Overall, very few high quality studies were identified, and there was insufficient rigor to generate reliable evidence on the effectiveness of interventions or their scalability. Most interventions were multiple component interventions, and most studies focused on outcomes such as self-reported falls incidence or awareness of falls prevention.

Conclusion: There is an opportunity to undertake an evaluation of a rigorously-designed, large-scale falls prevention program for community-dwelling older people in Mainland China. To help mitigate the rising burden of falls in Mainland China, recommendations for future falls prevention interventions have been made. These include: (1) target disadvantaged populations; (2) incorporate personalised interventions; and (3) investigate the effectiveness of those under-explored interventions, such as psychological, social environment, management of urinary incontinence, fluid or nutrition therapy and surgery. The study results will also potentially provide a useful evidence base for other low-and-middle income countries in a similar situation.

Keywords: China; Community; Falls prevention; Interventions; Older people.

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Conflict of interest statement

All authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram literature of search and review
Fig. 2
Fig. 2
The number of studies in 31 provinces of Mainland China* (*Provinces with seven or more studies are in dark grey)
See this image and copyright information in PMC

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