| Institution: | 1. Ageing Work and Health Research Group, Faculty of Health Sciences, The University of Sydney, Sydney, Australia;2. Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore;3. Department of Community and Clinical Allied Health, La Trobe Clinical School, La Trobe University, Melbourne, Australia;4. Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia;5. Saw Swee Hock School of Public Health, National University of Singapore, Singapore |
| Abstract: | ObjectiveTo identify the risk factors for falls in community stroke survivors.Data SourcesA comprehensive search for articles indexed in MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, and Web of Science databases was conducted.Study SelectionProspective studies investigating fall risk factors in community stroke survivors were included. Reviewers in pair independently screened the articles and determined inclusion through consensus. Studies meeting acceptable quality rating using the Q-Coh tool were included in the meta-analysis.Data ExtractionData extraction was done in duplicate by 4 reviewers using a standardized data extraction sheet and confirmed by another independent reviewer for completeness and accuracy.Data SynthesisTwenty-one articles met the minimum criteria for inclusion; risk factors investigated by ≥3 studies (n=16) were included in the meta-analysis. The following risk factors had a strong association with all fallers: impaired mobility (odds ratio OR], 4.36; 95% confidence interval CI], 2.68–7.10); reduced balance (OR, 3.87; 95% CI, 2.39–6.26); use of sedative or psychotropic medications (OR, 3.19; 95% CI, 1.36–7.48); disability in self-care (OR, 2.30; 95% CI, 1.51–3.49); depression (OR, 2.11; 95% CI, 1.18–3.75); cognitive impairment (OR, 1.75; 95% CI, 1.02–2.99); and history of fall (OR, 1.67; 95% CI, 1.03–2.72). A history of fall (OR, 4.19; 95% CI, 2.05–7.01) had a stronger association with recurrent fallers.ConclusionsThis study confirms that balance and mobility problems, assisted self-care, taking sedative or psychotropic medications, cognitive impairment, depression, and history of falling are associated with falls in community stroke survivors. We recommend that any future research into fall prevention programs should consider addressing these modifiable risk factors. Because the risk factors for falls in community stroke survivors are multifactorial, interventions should be multidimensional. |
