Association between dizziness and future falls and fall-related injuries in older adults: a systematic review and meta-analysis

Abstract

Background Dizziness is common in older adults, especially in those who have previously fallen. Yet, the association between dizziness and future falls has not been reviewed. This systematic review and meta-analysis aimed to investigate the association between dizziness and future falls and related injuries in older adults. Methods EMBASE, CINAHL Plus, SCOPUS, and PsycINFO databases were searched from inception to 5 February 2024. The review was registered on PROSPERO (CRD42022371839). Meta-analyses were conducted for the associations of dizziness with future falls (including recurrent and injurious falls). Heterogeneity was assessed using the Cochran's Q test, I2 and tau2 statistics. Three meta-analyses were performed on different outcomes (any-type falls (1+ falls), recurrent falls (2+ falls), and injurious falls). Results Twenty-nine articles were included in the systematic review (N=103,306). In a meta-analysis of 14 articles (N=46,795), dizziness was associated with significantly higher odds of any-type future falls (OR=1.63, 95% CI=1.44-1.84). In another meta-analysis involving 7 articles (N=5,630), individuals with dizziness also had a significantly higher odds of future recurrent falls (OR=1.98, 95% CI=1.62-2.42). For both meta-analyses, significant overall associations were observed even when adjusted for important confounding variables, indicating that dizziness independently predicts future falls. In contrast, a meta-analysis (3 articles, N=46,631 participants) revealed a lack of significant association between dizziness and future injurious falls (OR=1.12, 95% CI=0.87-1.45). Conclusions Dizziness is an independent predictor of future falls in older adults. These findings emphasise the importance of recognising dizziness as a risk factor for falls and implementing appropriate interventions.