ArticleBMC geriatrics2026
Falls and functional fitness among older adults in Sub-Saharan Africa: findings from the first population-based cross-sectional study in Ghana.
Article in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFalls are a leading cause of injury and disability among older adults worldwide, yet data from sub-Saharan Africa remain scarce. This study aimed to estimate the prevalence of fallers, recurrent fallers, and individuals at high risk of falls; identify associated sociodemographic and health-related factors; and examine the relationship between functional fitness and fall outcomes among older adults in Ghana, a country representative of the broader sub-Saharan African context.
methodsWe conducted a population-based cross-sectional study among 639 community-dwelling adults aged ≥ 60 years in urban and rural Ghana, using multi-stage sampling. Fall history over the past 12 months was assessed through self-report, and fall risk was evaluated using the 12-item Fall Risk Questionnaire. Functional fitness was measured using eight performance tests adapted from the Senior Fitness Test and Short Physical Performance Battery. Associations between fall outcomes, sociodemographic and health factors, and fitness measures were analysed using Poisson regression with robust variance and negative binomial regression models.
resultsThe prevalence of fallers, recurrent fallers, and high fall risk was 24.6%, 10.3%, and 30.2%, respectively. Female sex was strongly associated with both fallers and recurrent fallers. Rural residence was significantly associated with recurrent fallers. Moderate pain and high sedentary behaviour, were also linked to fallers. Fall risk scores were strongly associated with reported fall events, with psychological and strength-related items contributing most to fall outcomes. Poor lower limb strength, assessed using the five-times sit-to-stand test, was significantly associated with recurrent fallers (PR = 1.08; 95% CI: 1.04-1.13), while declines in any fitness domain were associated with elevated fall risk.
conclusionFalls are common among older adults in Ghana, with risk influenced by sex, residence, and functional status. Functional fitness plays a central role in fall risk, underscoring the value of targeted interventions to promote safe and healthy ageing in sub-Saharan Africa.
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