Prevalence of fall risk and fear of falling among older adults in the Middle East and North Africa: a systematic review and meta-analysis.
Karima Chaabna, Anupama Jithesh, Salina Khawaja et al.
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In 30 seconds
This systematic review and random-effects meta-analysis estimated fall risk and fear of falling among adults aged 60 years or older in the Middle East and North Africa (MENA). It included 109 studies with 213,877 participants, although evidence was unavailable for ten MENA countries. Pooled estimates varied by assessment tool: higher fall risk ranged from 33.4% using the Morse Fall Scale to 58.0% using the Timed Up and Go Test. Moderate to high concern about falling was estimated at 82.7% using the Falls Efficacy Scale-International. The authors reported substantial heterogeneity across studies.
Key findings
- Higher fall risk prevalence was 54.2% (95% CI = 35.1, 72.8) by the Missouri Alliance for Home Care Fall Risk Assessment and 33.4% (95% CI = 18.4, 53.8) by the Morse Fall Scale.
- Higher fall risk classification was 41.7% (95% CI = 27.6, 57.2) by the Berg Balance Scale and 58.0% (95% CI = 39.4, 74.5) by the Timed Up and Go Test.
- Moderate to high concern about falling was 82.7% (95% CI = 60.4, 93.8); reduced fall-related self-efficacy was 67.1% (95% CI = 44.9, 83.6).
- Meta-regression found no significant differences by population type, sex, or country-income level; substantial heterogeneity was observed.
Why it matters
The findings indicate that fall-related physical risk and fear of falling are common among older adults in the MENA populations represented in the evidence. Considering both dimensions may help clinicians and health systems identify needs that are not captured by a single measure. The estimates also highlight the importance of interpreting prevalence in light of the assessment tool used and the substantial variation between studies.
What to keep in mind
Substantial heterogeneity limits the comparability of pooled estimates, which differed by assessment tool. Data were unavailable for ten MENA countries, so the findings do not represent the entire region.