Toward An Improved Reporting of Fall Circumstances Among Community-Dwelling Older Adults: A Systematic Review and Reporting Guide for the 6 W's of Falls.

While much attention has been given to fall risk factors and outcomes among community-dwelling older adults, the specific circumstances of falls have been comparatively underexplored. This systematic review aimed to characterize data collection and reporting practices of fall circumstances. A systematic search of Medline, Embase, Scopus, ClinicalTrials.gov, and Cochrane Library from database inception-2026 identified studies reporting on the prevalence of specific fall circumstances. From 9,872 articles screened, 75 studies met the inclusion criteria and underwent data extraction. Circumstances were not consistently reported across studies; among the 11 domains that were evaluated, reporting of each circumstance ranged from 7 to 95% of studies. Concerns for study quality emerged due to failure to clearly define falls, use of long time periods between experiencing and reporting details of a fall, and only reporting circumstances of falls for a subset of falls that were collected without justification. To address issues with heterogeneity in reporting of fall circumstances, we propose a standardized interview and reporting guide based on these findings using the 6 W's framework: Who?, Where?, What?, When?, Why?, and HoW?. Use of this guide can lead researchers to greater consistency in reporting fall circumstances, ultimately enhancing the quality of future research and better informing fall prevention strategies.