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Risk factors for recurrent falls in older adults: a study protocol for a systematic review with meta-analysis
  1. Deborah A Jehu1,2,3,
  2. Jennifer C Davis2,4,
  3. Teresa Liu-Ambrose1,2,3
  1. 1Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
  2. 2Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
  3. 3Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
  4. 4Social & Economic Change Laboratory, Faculty of Management, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
  1. Correspondence to Dr Teresa Liu-Ambrose; teresa.ambrose{at}


Introduction Older adults who fall recurrently (i.e., >1 fall/year) are at risk for functional decline and mortality. Key risk factors for recurrent falls in community-dwelling older adults are not well established due to methodological limitations, such as recall bias. A better understanding of the risk factors for recurrent falls will aid in refining clinical practice guidelines for secondary fall prevention strategies. The primary objective of this systematic review with meta-analysis is to examine the risk factors for recurrent falls in prospective studies among community-dwelling older adults.

Methods and analysis A comprehensive search for articles indexed in MEDLINE, EMBASE, PsycINFO and CINAHL databases as well as grey literature was conducted on April 25, 2019. We will use MeSH and keyword search terms around the following topics: falls, recurrence, fall-risk, ageing and prospective studies. Prospective studies with monthly falls monitoring for 12 months, investigating risk factors for recurrent falls in older adults will be included. One author will complete the search. Two authors will remove duplicates and screen the titles and abstracts for their potential inclusion against the eligibility criteria. Two authors will screen the full texts and extract the data using a piloted extraction sheet. Included studies will be evaluated for the risk of bias with the Joanna Briggs Institute Prevalence Critical Appraisal tools. The quality of reporting will be determined with the Strengthening the Reporting of OBservational studies in Epidemiology. The data extraction will include study characteristics as well as sociodemographic, balance and mobility, sensory and neuromuscular, psychological, medical, medication and environmental factors. The results will be presented via figures, summary tables, meta-analysis (when possible) and narrative summaries.

Ethics and dissemination No ethics approval will be required. Findings will be disseminated through publication and media.

PROSPERO registration number CRD42019118888; Pre-results.

  • systematic review
  • meta-analysis
  • recurrent falls
  • risk factors
  • older adults

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors TLA, JCD and DAJ developed the research question. DAJ registered the protocol and wrote the first draft of the manuscript. DAJ and JCD developed the search strategy and created the data extraction form. JCD and TLA provided critical review and feedback at each stage of the process. All authors critically reviewed and edited the final manuscript.

  • Funding Dr Liu-Ambrose is a Canada Research Chair (Tier 2) in Physical Activity, Mobility, and Cognitive Neuroscience, Department of Physical Therapy, University of British Columbia. Dr. Jehu is a funded postdoctoral fellow through the Michael Smith Foundation for Health Research. The funders played no role in the design of this study.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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