Environmental hazards and risk of fall in the elderly: systematic review

Falls in the elderly is the result of a complex interplay between intrinsic and extrinsic factors. Although it is difficult to separate these factors, studies indicate that environmental hazards are involved in approximately 40% of the falls. This study aimed to conduct a systematic review about the contribution of environmental hazards for falls in community-dwelling elderly. Studies published from January 2000 to May 2014 in the electronic databases MEDLINE, LILACS and SciELO were selected. Only free full-text articles written in English, Portuguese and Spanish were considered for this research. After title, abstract and full text analysis, ten articles were included in this review. In the studies analyzed, approximately half of the falls occurred during walk and involved tripping and slipping. The environmental risk factors are present in falls (20-58%), in which irregular surfaces, wet/slippery floors, objects/loose rugs and uneven floor/steps were the most prevalent hazards among the studies. There was tendency of increase in the occurrence of outdoor falls, which are often caused by extrinsic factors. More studies are needed to characterize and develop strategies to prevent outdoor falls among community-dwelling older adults.

老年人跌倒是内在因素与外在因素复杂交互作用的结果。尽管难以完全区分两类因素，但现有研究表明，约40%的跌倒事件与环境危险因素相关。本研究旨在针对环境危险因素对社区居住老年人跌倒的影响开展系统综述。研究筛选范围为2000年1月至2014年5月期间发表于MEDLINE、LILACS及SciELO电子数据库的文献，仅纳入以英语、葡萄牙语及西班牙语撰写的免费全文文献。经标题、摘要及全文筛选评估后，最终共有10篇文献纳入本次综述。纳入分析的研究显示，约半数跌倒事件发生于行走过程中，且与绊倒、滑倒相关。环境危险因素存在于20%~58%的跌倒事件中，其中路面不平整、潮湿/湿滑地面、杂物/松动地毯以及台阶/地面凹凸不平是各研究中最常见的危险因素。户外跌倒的发生呈上升趋势，此类跌倒通常由外在因素诱发。未来仍需开展更多研究，以明确社区居住老年人户外跌倒的特征并制定相应的预防策略。