Prevalence and risk factors of falls among community-dwelling older adults in Sri Lanka: A systematic review

Background: Falls have a significant negative impact on health, mobility and survival, particularly among older adults. Despite the clinical relevance, falls are not adequately studied in Sri Lanka, and this scoping review assessed the limited information on the prevalence and risk factors of falls among community-dwelling older adults in Sri Lanka.

Methods: Original studies published in PubMed, Ovid, and Google Scholar were searched using the key terms “falls”, AND “prevalence” OR “incidence” OR “risk factors” OR “determinants” AND “elderly” OR “older adults” AND “Sri Lanka”. The PRISMA guidelines were followed in selecting articles.

Results: The original search retrieved 13 articles; only 3 met the selection criteria. They included a total of 2010 community dwelling older adults aged ≥60 years. The prevalence of falls ranged from 258 to 508 per 1000 people. The common risk factors identified were; falls in the previous year (OR=4.65), disability (OR=2.04), house risk level (OR=1.68), advanced age (OR=3.4), female gender (OR=3.0), being employed (OR=3.6), diabetes mellitus (OR=2.7), balance or gait problems (OR=4.2), and been on at least one longterm medication (OR=3.5).

Conclusions: Evidence related to falls is scarce in Sri Lanka, and limited data show that approximately one-fourth to half of older adults in the community experience at least a single fall, while the female gender, disability, comorbidity, and medication use are significant contributory factors. This review highlights a clear gap in the knowledge of falls among older adults in Sri Lanka.