Evidence map›Paper›PMID 40197783›Full record

SynthesisAge and ageing2025

Does concern about falling predict future falls in older adults? A systematic review and meta-analysis.

Toby Jack Ellmers, Jodi P Ventre, Ellen Freiberger, Klaus Hauer, David B Hogan, Mei Ling Lim, Lisa McGarrigle, Samuel Robert Nyman, Chris J Todd, Yuxiao Li and 1 more

Erratum issuedAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Age and ageing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 33 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Toby Jack EllmersDepartment of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK.ORCID 0000-0001-9595-6360
Jodi P VentreNational Institute for Health and Care Research, Applied Research Collaboration- Greater Manchester & School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
Ellen FreibergerGeriatric Center, Medical Faculty Heidelberg, Heidelberg University, Rohrbacher Straße 149, 69126, Heidelberg, Germany.ORCID 0000-0002-6506-6276
Klaus HauerBethanien Hospital, Geriatric Centre at the Heidelberg University, Heidelberg 69126, Germany.
David B HoganProfessor Emeritus, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.ORCID 0000-0002-9462-5460
Mei Ling LimFalls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia & School of Population Health, University of New South Wales, Sydney, Australia & Neurology, The George Institute for Global Health, Sydney, Australia.ORCID 0000-0001-9898-5474
Lisa McGarrigleSchool of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.ORCID 0000-0002-0533-3029
Samuel Robert NymanDepartment of Psychology, Faculty of Humanities & Social Sciences, University of Winchester, Winchester, UK.ORCID 0000-0003-1963-0814
Chris J ToddNational Institute for Health and Care Research, Applied Research Collaboration - Greater Manchester & School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK/& Manchester Academic Health Science Centre, Manchester, UK & Manchester University NHS Foundation Trust.ORCID 0000-0001-6645-4505
Yuxiao LiDepartment of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK.ORCID 0000-0002-7499-7638
Kim DelbaereFalls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW 2031, Australia & School of Population Health, University of New South Wales, Sydney, Australia.ORCID 0000-0002-5655-0234

Funding

National Health and Medical Research Council 1193766National Institute for Health and Care Research (NIHR) Policy Research Unit in Older People and Frailty PR-PRU-1217-2150NIHR Policy Research Unit in Healthy Ageing NIHR206119Wellcome TrustWellcome Trust Sir Henry Wellcome Postdoctoral Fellowship 222747/Z/21/Z
6 · The paper itself

Abstract

backgroundThe 2022 World Falls Guidelines recommend assessing concerns (or 'fears') about falling in multifactorial fall risk assessments. However, the evidence base for this recommendation is limited. This review evaluated the evidence for concerns about falling as an independent predictor of future falls, applying the Bradford Hill criteria for causality.

methodsSystematic review and meta-analyses were conducted (PROSPERO registration ID: CRD42023387212). MEDLINE, CINAHL Plus, Web of Science and PsycINFO were searched for studies examining associations between baseline concerns about falling and future falls in older adults (minimum 6-month follow-up). Meta-analyses examined associations between concerns about falling and future falls. Risk of bias was assessed using an adapted Newcastle Ottawa Scale for cohort studies, and evidence certainty was rated with GRADE.

resultsAbout 53 studies, comprising 75,076 participants, were included. Meta-analysis showed significant independent association between baseline concerns and future falls when using the Falls Efficacy Scale-International to assess concerns (full scale version, pooled OR = 1.03 [95% CI = 1.02-1.05] per 1-point increase; short scale version, pooled OR = 1.08 [95% CI = 1.05-1.11]). Significant associations were also observed when using single-item measures of concerns (pooled OR = 1.60 [95% CI = 1.36-1.89] for high vs. low concerns). In contrast, balance confidence (Activities-Specific Balance Confidence Scale) did not predict future falls (pooled OR = 0.97 [95% CI = 0.93-1.01]). Despite 26 studies rated as poor quality, associations were consistent across studies of different quality. The overall certainty of the evidence was rated as moderate.

conclusionsBaseline concern about falling is a clear predictor of future falls in older adults, supporting its inclusion in fall risk assessments. Regular assessment of concerns about falling, along with targeted interventions, could help reduce the risk of falls in older adults.

Indexed as

Accidental FallsAgingFearAgedAged, 80 and overAge FactorsFemaleGeriatric AssessmentHumansMalePostural BalanceRisk AssessmentRisk Factorsbalance confidencefall risk assessmentfalls efficacyfear of fallingolder peoplesystematic review

Identifiers

PMID40197783
PMCPMC11976718

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.