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.

Keywords: Ethnicity; Falls; Older adults; Prevalence.

Fig. 1

PRISMA flowchart of the article selection process [21]

Fig. 2

Fall prevalence for Asian ethnicity (I²v = 32.02, p < 0.001, Qv = 22.07)

Fig. 3

Fall prevalence for Black ethnicity (I²v = 17.57, p < 0.001, Qv = 8.49)

Fig. 4

Fall prevalence for Hispanic ethnicity (I²v = 55.49, p < 0.001, Qv = 4.49)

Fig. 5

Fall prevalence for White ethnicity (I²v = 18.96, p < 0.001, Qv = 13.57)