Multiple-Level Fall Risks Associated with Socioeconomic Factors Among Community-Dwelling Older Adults: A Systematic Review

Abstract

Falls among the community-dwelling elderly is a significant challenge to individual, community, and public health, and is a leading cause of fatal and non-fatal injuries among older adults. The aim of this review study was to identify and synthesize the relevant peer-reviewed literature on multi-level fall risks associated with socioeconomic factors among community-dwelling older adults. A systematic search was conducted across six electronic databases from 2001-2022. Of the retrieved 235 articles, 146 articles were excluded at the title and abstract screening. Fifty-six articles underwent full-text screening and further narrowed to 36 studies matching the expected criteria. The review study findings revealed that individual and socioeconomic factors contributing to older adults falling or risk of falls were sociodemographic, education, income, literacy, marital status, employment, medication, physical/cognitive functions, and frailty phenotype. Females with limited literacy, low-moderate family income, depression symptoms, lower/upper extremity functional limitation, and balance limitation had a higher prevalence of falls. Community and built environmental features can also affect the fall risks of community-dwelling older adults beyond the contributions of individual-level fall risk factors including neighborhood, built environment, housing, home-living environment, and residence (urban or rural dwelling). Understanding the relevant multi-level (individuals and community, etc.) related risks of falls associated with socioeconomic factors can be tremendously important and beneficial. The findings from this review study can be useful for the healthcare systems engineers and related community health professionals for the development and design of future research and intervention strategies.