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Falls and Risk Factors for Falls among Older Adult Populations: Implications for Treatment and Monitoring Strategies

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 11185

Special Issue Editors

Prof. Dr. Deborah A. Jehu

E-Mail Website
Guest Editor
Interdisciplinary Health Sciences Department, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA
Interests: aging; falls; falls-risk; balance; cognition; therapeutic intervention
Dr. Ryan S. Falck

E-Mail Website
Guest Editor
School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
Interests: aging; cognitive health; frailty; lifestyle medicine; epidemiology; biostatistics

Special Issue Information

Dear Colleagues, 

The population is aging, and falls are an increasing health concern among older adults. Approximately one-third of older adults fall each year, with a two-fold increase for those with cognitive impairment and neurological disorders. Falls and related injuries are associated with the following risk factors: (1) balance and mobility; (2) environment (e.g., loose carpeting); (3) psychological factors; (4) medical concerns; (5) medication; (6) sensory and neuromuscular issues; and (7) sociodemographic. Falls and related injuries can be prevented through targeted fall prevention interventions, such as strength and balance exercise, medication adjustment, and home hazard review, among others. 

This Special Issue of International Journal of Environmental Research and Public Health (IJERPH) will focus on the current state of knowledge on falls and their risk factors among older adult populations. We will accept manuscripts from a range of disciplines, examining any aging population aged 55 years and older, which aim to provide a better understanding of fall risk factors, improve fall risk assessments, or advance fall prevention interventions. Original research papers, reviews, case reports, methodological papers, position papers, brief reports, and commentaries are welcome.

Prof. Dr. Deborah A. Jehu
Dr. Ryan S. Falck
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • aging
  • falls
  • falls risk factors
  • frailty
  • therapeutic intervention

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Published Papers (4 papers)

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11 pages, 937 KiB  
Article
Risk Factors for Falls and Fall-Related Fractures in Community-Living Older People with Pain: A Prospective Cohort Study
by Tatsuya Hirase, Yoshiro Okubo, Kim Delbaere, Jasmine C. Menant, Stephen R. Lord and Daina L. Sturnieks
Int. J. Environ. Res. Public Health 2023, 20(11), 6040; https://doi.org/10.3390/ijerph20116040 - 2 Jun 2023
Viewed by 2788
Abstract
(1) Background: This prospective study aimed to identify predictors of falls and fall-related fractures in community-dwelling older people with pain; (2) Methods: Participants comprised 389 community-dwelling older people aged 70+ years who had musculoskeletal pain in the neck, back, hip, leg/knee and/or feet. [...] Read more.
(1) Background: This prospective study aimed to identify predictors of falls and fall-related fractures in community-dwelling older people with pain; (2) Methods: Participants comprised 389 community-dwelling older people aged 70+ years who had musculoskeletal pain in the neck, back, hip, leg/knee and/or feet. Demographic, anthropometric, balance, mobility, cognitive function, psychological status and physical activity level measures were obtained at baseline. Falls were monitored with monthly falls calendars for 12 months. Logistic regression analyses were performed to identify predictors of falls and fall-related fractures during a 12-month follow-up; (3) Results: Of the 389 participants, 175 (45.0%) and 20 (5.1%) reported falls and fall-related fractures during the 12-month follow-up, respectively. Greater postural sway on foam, more depressive symptoms and lower physical activity levels at baseline were associated with falls during the 12-month follow-up. Slower walking speed at baseline was associated with fall-related fractures during the 12-month follow-up. These associations remained significant after adjusting for age, sex, body mass index, comorbidities and medication use; (4) Conclusions: This study suggests poor balance, low mood and a less active lifestyle are predictors of falls, and slower walking speed predicts fall-related fractures among community-dwelling older people with pain. Full article
(This article belongs to the Special Issue Falls and Risk Factors for Falls among Older Adult Populations: Implications for Treatment and Monitoring Strategies)
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11 pages, 1236 KiB  
Article
Does Cognitive Training Reduce Falls across Ten Years?: Data from the ACTIVE Trial
by Briana N. Sprague, Lesley A. Ross and Karlene K. Ball
Int. J. Environ. Res. Public Health 2023, 20(6), 4941; https://doi.org/10.3390/ijerph20064941 - 11 Mar 2023
Cited by 2 | Viewed by 4007
Abstract
The purpose of this study was to examine the effect of cognitive training on the risk of experiencing a fall across 10 years. The study used data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized controlled trial. Older adults [...] Read more.
The purpose of this study was to examine the effect of cognitive training on the risk of experiencing a fall across 10 years. The study used data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized controlled trial. Older adults aged 65–94 were randomly assigned to speed of processing, memory, or reasoning training or to a no-contact control group (n = 2802). The experience of a fall in the prior two months was assessed at baseline and at 1, 2, 3, 5, and 10 years posttest. Cox proportional hazards explored group differences in the total sample, as well as group differences for participants classified as low risk (n = 2360) and high risk (n = 442) for future falls. The data were censored at the first reported fall postbaseline. After baseline, 983 (35.08%) participants across the full sample reported a fall. There were no significant effects of the training in the full sample or in the low-risk sample of participants. However, the participants at greater risk for future falls in the speed of processing training group were 31% less likely (HR = 0.69; 95% CI = 0.48, 0.998, p = 0.049) to experience a subsequent fall across ten years compared to the control group. Reasoning and memory training did not reduce a future fall in the high-risk sample. The speed of processing training reduced the risk of future falls across ten years in the high-risk participants. Future work should examine moderators and mediators of training in at-risk samples. Full article
(This article belongs to the Special Issue Falls and Risk Factors for Falls among Older Adult Populations: Implications for Treatment and Monitoring Strategies)
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12 pages, 1450 KiB  
Systematic Review
Effect of Blood Flow Restriction on Gait and Mobility in Older Adults: A Systematic Review and Meta-Analysis
by Katherine L. Hsieh, Andrew Foster, Logan MacIntyre and Reagan Carr
Int. J. Environ. Res. Public Health 2024, 21(10), 1325; https://doi.org/10.3390/ijerph21101325 - 7 Oct 2024
Viewed by 1455
Abstract
Older adults demonstrate gait impairments that increase their risk for falls. These age-related mobility impairments are in part due to declines in muscle mass and strength. High-intensity exercise can improve muscle strength and mobility but may not be tolerable for older adults due [...] Read more.
Older adults demonstrate gait impairments that increase their risk for falls. These age-related mobility impairments are in part due to declines in muscle mass and strength. High-intensity exercise can improve muscle strength and mobility but may not be tolerable for older adults due to musculoskeletal injury and pain. Blood flow restriction (BFR) with lower-intensity exercise offers a strategy that may be more tolerable for older adults, but whether BFR improves gait and mobility in older adults is unclear. The purpose of this systematic review and meta-analysis was to determine the effect of BFR on gait and mobility in healthy older adults. PubMed, Embase, Cochrane Library, and CINAHL were systematically searched for articles utilizing BFR in older adults. Articles were included if adults were over 60 years, did not have chronic health conditions, had undergone randomized controlled trials, and presented objectively measured gait outcomes. The search identified 1501 studies, of which 9 were included in the systematic review and 8 studies in the meta-analysis. Outcome measures included the Timed Up and Go (TUG), 6-Minute Walk Test (6MWT), 400 m walk test, Short Physical Performance Battery (SPPB), and 10 m walk test. Meta-analyses found improvements in the TUG (mean difference (MD) = −0.71; 95% CI = −1.05, −0.37; p < 0.001) and SPPB (MD = −0.94; 95% CI = −1.48, −0.39; p < 0.001) in BFR compared to no BFR. There were no differences in gait speed (MD = 0.59; 95% CI = −0.22, 1.41; p = 0.16). BFR may be effective for gait and mobility tasks over shorter distances. Clinicians may consider incorporating BFR to improve mobility and gait function in older adults. Full article
(This article belongs to the Special Issue Falls and Risk Factors for Falls among Older Adult Populations: Implications for Treatment and Monitoring Strategies)
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13 pages, 576 KiB  
Study Protocol
Telerehabilitation in Low-Resource Settings to Improve Postural Balance in Older Adults: A Non-Inferiority Randomised Controlled Clinical Trial Protocol
by Valeska Gatica-Rojas and Ricardo Cartes-Velásquez
Int. J. Environ. Res. Public Health 2023, 20(18), 6726; https://doi.org/10.3390/ijerph20186726 - 7 Sep 2023
Cited by 1 | Viewed by 1849
Abstract
Background: Several exercise methods with virtual reality devices have been used in treatments for older adults and patients with neurodegenerative diseases, although the mechanisms continue to be elucidated. The aim of this study is to establish the feasibility and effectiveness of a rehabilitation [...] Read more.
Background: Several exercise methods with virtual reality devices have been used in treatments for older adults and patients with neurodegenerative diseases, although the mechanisms continue to be elucidated. The aim of this study is to establish the feasibility and effectiveness of a rehabilitation programme using low-cost virtual reality aimed at improving postural balance in older adults. It also seeks to compare low-cost virtual reality under two delivery modalities, telerehabilitation (TR) in elderly centres and face-to-face (FtF) in rehabilitation centres. Methods: The study is set up as a non-inferiority two-arm parallel triple-blind randomised controlled clinical trial. Sixteen persons aged 65 to 75-years-old will be included. Eighteen Wii therapy sessions (25–30 min) will be provided through both FtF (control group, n = 8) and TR (exposure group, n = 8), both with a Nintendo Wii balance board. Data will be collected at baseline (week 0), during the Wii therapy sessions (weeks 2, 4, and 6), and during the follow-up (weeks 8 and 10). The primary outcome will be the area of centre-of-pressure (CoP) sway; secondary outcomes will be medial–lateral and anterior–posterior velocity and standard deviation of CoP; and tertiary outcomes will be clinical measures: single-leg stand, timed up-and-go tests, Barthel Index, and Tinetti’s scale. Statistical analyses will be performed using SPSS 20.00 for Windows. The trial adheres to the Declaration of Helsinki and the Chilean laws of rights and duties of the patient and research in humans. Ethical approval was obtained from the Ethics Committee of the University of Talca. Written informed consent will be obtained from participants. Discussion: In this trial, older adults from a Chilean city with a large rural and underserved population share will be included to test the feasibility and effectiveness of a rehabilitation programme using low-cost VR aimed at improving postural balance to generate evidence to support decision makers generating public health policy. Trial registration: Australian New Zeeland Clinical Trials Registration (ACTRN12621001380886). Full article
(This article belongs to the Special Issue Falls and Risk Factors for Falls among Older Adult Populations: Implications for Treatment and Monitoring Strategies)
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