To determine the prevalence of falls and fall-related injuries in community-dwelling older adults over the age of 60 who have been diagnosed with any type of cancer, and examine whether falls prevalence varies with specific cancer characteristics.
A systematic literature search of five health-related electronic databases was conducted from inception to November 2023. Studies were included if the following criteria were met: (1) included community-dwelling adults with a mean age of ≥60 years who have a current or past diagnosis of cancer; (2) reported data on the prevalence of falls and/or fall-related injuries; (3) includes ≥50 participants; and (4) full papers published in English. Pooled prevalence rates of falls or fall-related injuries were calculated using meta-analysis, and meta-regression was used to investigate the association between cancer characteristics (e.g. type of cancer) and reported prevalence of falls.
57 studies with sample sizes ranging from 51 to 146,959 participants (mean age 73 years) were included. Most studies included participants with different types of cancers, the most common being breast (34 studies; 59%), lung (31 studies; 53%) and colorectal cancer (26 studies; 45%). All but four studies collected falls data retrospectively and with varying timeframes ranging from four weeks to two years. The number of fallers was the most commonly reported outcome (48 studies; 84%). The pooled estimate of the proportion of older adults with cancer who experienced a fall in the last 6-months was 25% (95% CI 19%, 32%). A similar prevalence was observed for those who experienced a fall in the last 12-months (29%; 95% CI 24%, 34%). No association was observed between cancer type and the number of fallers, although subgroup analyses showed that the pooled prevalence of falls among older adults with breast cancer was slightly higher (26%; 95% CI 22%, 30%) compared to those with prostate (14%; 95% CI 9%, 20%) and colorectal cancer (13%; 95% CI 11%, 16%). However, only a limited number of studies were included in this analysis.
The overall prevalence of falls in community-dwelling older adults with a diagnosis of any type of cancer is relatively similar to the known prevalence of falls in the general older adult population. There are, however, known limitations of asking participants to recall fall events so fall events may have been under-reported in the studies included in this review.
Falls are a significant health burden in this population given the increasing longevity among cancer survivors with significant improvements in treatment and supportive care, plus population ageing. It is important for future studies to consider the interaction between exposure to falls risk such as physical activity levels with falls, as well as any associations with medications used to manage cancer and its sequelae.
Cancer
Older adult
