Age and ageing · 2026
Emergency department-initiated interventions to reduce risk of recurrent falls in older adults: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Charmant Wilmar, Jansen Sofie, van Schoor Natasja M, de Vries Ralph, Nanayakkara Prabath, Willems Hanna C, van der Velde Nathalie
Аннотация
BACKGROUND: Older adults presenting to the emergency department (ED) following a fall are at high risk for recurrent falls, injuries and increased healthcare utilisation. This systematic review and meta-analysis evaluated the effectiveness of interventions initiated upon ED presentation in reducing falls (primary outcome) and fall-related outcomes (secondary outcomes) among older adults.
METHODS: A comprehensive search was performed in Ovid Medline, Embase, CINAHL, PEDro, Web of Science, and Scopus up to June 2025, following PRISMA guidelines. This yielded 9624 references, of which 4811 records remained after deduplication and were screened for eligibility. Meta-analyses and descriptive methods, including vote counting, were applied where appropriate. Sensitivity and subgroup analyses were conducted.
RESULTS: Thirty articles were included. Interventions were associated with a significant reduction in fall incidence (rate ratio 0.69; 95% CI 0.54-0.88; I2 = 95%), supported by vote counting. While reductions were also observed in the proportion of fallers (odds ratio 0.87; 95% CI 0.71-1.07; I2 = 61%), fall-related and all-cause ED revisits, hospital admissions, recurrent falls and mortality, these trends did not reach statistical significance. Sensitivity analysis excluding studies with modified usual care showed a significant reduction in fall-related ED revisits and people sustaining an injurious fall. Secondary outcomes including quality of life, fear of falling and physical functioning generally showed trends favouring the intervention group. Considerable heterogeneity and variation in intervention characteristics were noted across studies.
CONCLUSION: Interventions for older adults presenting to the ED after a fall suggest a favourable effect on fall rate. Non-significant trends favouring the intervention group were observed for several other outcomes, but heterogeneity and methodological limitations preclude definitive conclusions.
METHODS: A comprehensive search was performed in Ovid Medline, Embase, CINAHL, PEDro, Web of Science, and Scopus up to June 2025, following PRISMA guidelines. This yielded 9624 references, of which 4811 records remained after deduplication and were screened for eligibility. Meta-analyses and descriptive methods, including vote counting, were applied where appropriate. Sensitivity and subgroup analyses were conducted.
RESULTS: Thirty articles were included. Interventions were associated with a significant reduction in fall incidence (rate ratio 0.69; 95% CI 0.54-0.88; I2 = 95%), supported by vote counting. While reductions were also observed in the proportion of fallers (odds ratio 0.87; 95% CI 0.71-1.07; I2 = 61%), fall-related and all-cause ED revisits, hospital admissions, recurrent falls and mortality, these trends did not reach statistical significance. Sensitivity analysis excluding studies with modified usual care showed a significant reduction in fall-related ED revisits and people sustaining an injurious fall. Secondary outcomes including quality of life, fear of falling and physical functioning generally showed trends favouring the intervention group. Considerable heterogeneity and variation in intervention characteristics were noted across studies.
CONCLUSION: Interventions for older adults presenting to the ED after a fall suggest a favourable effect on fall rate. Non-significant trends favouring the intervention group were observed for several other outcomes, but heterogeneity and methodological limitations preclude definitive conclusions.