Epidemiology of falls in community-dwelling older adults in Europe: a systematic review and meta-analysis

Abstract

Objectives: Falls have long been recognised as a frequent problem among older adults and have been cited in literature since the 1950s. Given extensive research on risk factors, prevention, and implementation strategies, one might expect a decline in fallers prevalence. The aim of this review is to explore the epidemiology of falls in Europe, focusing on healthy, community-dwelling individuals aged 65 years or older.

Methods: Articles for this systematic review and meta-analysis were sourced from PubMed and Web of Science in June 2023, with screening completed by August 2023 and an update in January 2024. Risk of bias assessment used the Standard quality assessment criteria and potential outliers were identified. Publication bias was assessed using Egger's regression test. Data analysis was performed in R.

Results: Thirty-eight articles were included, comprising a sample of 71 245 European, community-dwelling older adults. The average fallers prevalence among European older adults was 30% (95% CI 0.26-0.34). Meta-regression analysis showed no significant change in fallers prevalence over the years (P = .66), in contrast with meta-regression for average age (P < .01). In the subgroup analysis, differences in fallers prevalence were seen for gender (P < .01), country (P < .01), and length of follow-up (P = .02).

Conclusion: Despite decades of evidence supporting effective fall prevention, there is no significant change in the prevalence of fallers among community-dwelling older adults in Europe. Future research should focus on systematically identifying the factors contributing to the persistent fall rates. Additionally, efforts must be made to ensure effective implementation of existing knowledge on fall prevention.

Keywords: epidemiology; falls; meta-analysis; older adults; older people; prevalence; systematic review.