Prevalence of falls and associated factors in community-dwelling older Brazilians: a systematic review and meta-analysis

Falls determine huge epidemiological, clinical, and economic burden in the older population worldwide, presenting high odds of severe disability. The present study aimed to estimate the prevalence of falls and associated factors in older Brazilians using a systematic review with meta-analysis. Searches were performed in SciELO, PubMed, LILACS, Web of Science, Scopus and PsycINFO databases with no date or language restrictions. Studies on community-dwelling older persons aged ≥ 60 years from both sexes and with a sample size of ≥ 300 participants included. Exclusion criteria were studies conducted specifically for older adults diagnosed with chronic disabling diseases that predispose them to falls. Risk of bias of included studies was assessed using a critical appraisal tool focusing on prevalence designs. A random-effects meta-analysis was used to pool the prevalence of falls across studies. Exploratory analysis was conducted examining subgroup estimates, prevalence ratios and meta-regression. Thirty-seven studies involving 58,597 participants were included. Twelve-month prevalence of falls was 27% (95%CI: 24.3-30.0), with significantly higher estimates in female than male (PR = 1.57; 95%CI: 1.32-1.86), in age group ≥ 80 years than age group 60-69 years (PR = 1.46; 95%CI: 1.15-1.84), and in participants from the Central region than participants from the South region (PR = 1.36; 95%CI: 1.10-1.69) of Brazil. Risk of bias scores did not impact heterogeneity in the 12-month meta-analysis. These estimates strongly support evidence-based public interventions to prevent falls in older Brazilians, especially in women and the oldest-old population.

跌倒在全球老年人群中造成了沉重的流行病学、临床与经济负担，且会大幅提升严重残疾的发生风险。本研究旨在通过系统综述结合元分析（meta-analysis），评估巴西老年人群的跌倒患病率及其相关影响因素。研究团队在SciELO、PubMed、LILACS、Web of Science、Scopus及PsycINFO数据库中开展文献检索，未设置检索日期与语言限制。纳入标准为针对年龄≥60岁、涵盖两性、样本量≥300名的社区居住老年人开展的研究；排除标准为专门针对确诊患有慢性致残性疾病（此类疾病会增加跌倒风险）的老年人群开展的研究。采用针对患病率研究设计的关键评价工具，对纳入研究的偏倚风险进行评估。采用随机效应元分析模型，对各项研究的跌倒患病率数据进行合并分析；同时开展探索性分析，涵盖亚组估计、患病率比（prevalence ratio）与元回归分析。最终纳入37项研究，共涉及58597名受试者。12个月内跌倒的总体患病率为27%（95%置信区间：24.3~30.0）；其中女性患病率显著高于男性（患病率比PR=1.57；95%CI：1.32~1.86），≥80岁年龄组患病率显著高于60~69岁年龄组（PR=1.46；95%CI：1.15~1.84），且巴西中部地区受试者的跌倒患病率显著高于南部地区（PR=1.36；95%CI：1.10~1.69）。在12个月跌倒患病率的元分析中，偏倚风险评分未对研究异质性产生显著影响。上述研究结果可为巴西老年人群跌倒预防的循证公共卫生干预措施提供有力依据，尤其适用于女性与高龄老年群体。