Systematic review of fall-related factors among the house-dwelling elderly in Japan

BACKGROUND: Fall-related factors and individual characteristics of the elderly who have had fall are necessary to develop practical fall prevention programs, and life support management. However, no nation-wide meta-analysis of the fall-related factors of elderly has been performed in Japan. OBJECTIVES: To conduct a meta-analysis concerning fall-related factors among the house-dwelling elderly in Japan. DATA SOURCES: Japana Centra Revuo Medicina, version 3 (systematic literature search system for Japanese literature), and Pub Med (a service of the National Library of Medicine) from January 1994 to December 2003. METHODS: Study search terms included the following: retrograde case-control, prospective cohort, and retrospective cohort study with falls. Search terms included older adults (60 years and over), falls and humans. Thirty-two fall-related factors were meta-analyzed. RESULTS: Among 32 fall-related factors, only nine factors were statistically proven to be related to falls. These factors were female gender, age over 70 years old, fall experience, past history of cerebrovascular disease, grip strength, knee extensor strength, one foot standing time with eyes open, one foot standing time with eyes closed, and skinfold thickness (female). Eleven factors: presence of a spouse, past medical history of hypertension, complaints of dizziness, numbness of the extremities, 10 meter maximum walking velocity, tendency to stumble, use of supportive equipment, standing postural sway. sitting trunk flexion, skinfold thickness (male), and body mass index, were not statistically proven to be related to falls. CONCLUSIONS: More studies are necessary to determine the efficacy of fall-related factors among the Japanese elderly.