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Falls in older adults with cancer: an updated systematic review of prevalence, injurious falls, and impact on cancer treatment

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Abstract

Purpose

This update of our 2016 systematic review answers the following questions: (1) How often do older adults with cancer fall? (2) What are the predictors for falls? (3) What are the rates and predictors of injurious falls? (4) What are the circumstances and outcomes of falls? (5) How do falls in older patients affect subsequent cancer treatment? and a new research question, (6) Which fall reduction interventions are efficacious in this population?

Methods

MEDLINE, PubMed, CINAHL, and Embase were searched (September 2015–January 25, 2019). Eligible studies included clinical trials and cohort, case-control, and cross-sectional studies published in English in which the sample (or subgroup) included adults aged ≥ 60, with cancer, in whom falls were examined as an outcome.

Results

A total of 2521 titles were reviewed, 67 full-text articles were screened for eligibility, and 30 new studies were identified. The majority involved the outpatient setting (n = 19) utilizing cross-sectional method (n = 18). Sample size ranged from 21 to 17,958. Fall rates ranged from 1.52 to 3.41% per 1000 patient days (inpatient setting) and from 39%/24 months to 64%/12 months (outpatient setting). One out of the 6 research questions contributed to a new finding: one study reported that 1 in 20 older patients experienced impact on cancer treatment due to falls. No consistent predictors for falls/fall injuries and no studies on fall reduction interventions in the geriatric oncology setting were identified.

Conclusion

This updated review highlights a new gap in knowledge pertaining to interventions to prevent falls. Additionally, new knowledge also emerged in terms of impact of falls on cancer treatment; however, further research may increase generalizability. Falls and fall-related injuries are common in older adults with cancer and may affect subsequent cancer treatment. Further studies on predictors of falls, subsequent impacts, and fall reduction in the oncology setting are warranted.

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Funding

The research of Schroder Sattar has been funded by a recruitment and retention fund from the University of Saskatchewan and by an establishment grant from the Saskatchewan Health Research Foundation.

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Author notes

  1. Drs. Tanya Wildes and Shabbir Alibhai are joint-senior authors for this paper.

Authors and Affiliations

  1. College of Nursing, University of Saskatchewan, 4400 4th Avenue, Room 108, Regina, Saskatchewan, S4T 0H8, Canada

    S. Sattar

  2. College of Nursing, University of Saskatchewan, Saskatoon, Canada

    K. Haase

  3. Faculty of Kinesiology & Health Studies, University of Regina, Regina, Canada

    S. Kuster

  4. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada

    M. Puts

  5. Kirkhof College of Nursing, Grand Valley State University, Grand Rapids, MI, USA

    S. Spoelstra

  6. Library, University of Regina, Regina, Canada

    C. Bradley

  7. Division of Medical Oncology, Washington University School of Medicine, St Louis, MO, USA

    T. M. Wildes

  8. Department of Medicine, Institute of Health Policy, Management, and Evaluations, University of Toronto, Toronto, Canada

    S. Alibhai

  9. University Health Network, Toronto, Canada

    S. Alibhai

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Sattar, S., Haase, K., Kuster, S. et al. Falls in older adults with cancer: an updated systematic review of prevalence, injurious falls, and impact on cancer treatment. Support Care Cancer 29, 21–33 (2021). https://doi.org/10.1007/s00520-020-05619-2

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