Table 1. Summary of the 38 studies included in the present meta-analysis.
| Study [Reference] | Country | Source of sample | Population characteristics | No. of total participants | Definition of falls/ No. of participants with falls | Definition and type of UI/ No. of participants with UI | Relative risk (95% CI) | Risk of bias |
|---|---|---|---|---|---|---|---|---|
| Tinetti ME et al. 1995 [14] | USA | Community dwelling adults, aged 72 years and older | Mean age: 79.7 Women:73% | 927 | At least two falls in 1 year | At least one UI / week in 1 year | Crude OR: 1.9 (95% CI, 1.2–2.9) | Critical |
| 96 | 146 | |||||||
| Luukinen H et al. 1996 [15] | Finland | Community dwelling adults, aged 70 years and older | Mean age: 76.1 | 1,016 | At least two falls in 1 year | UI during the past 2 years | Adjusted a OR: 1.70 (95% CI, 1.03–2.89) | Serious |
| Men: 396 Women: 620 | 88 | 158 | ||||||
| Johansson C et al. 1996 [9] | Sweden | Community dwelling women, aged 85 year old | Mean age: 85 | 658 | At least one falls | UI monthly, weekly, several/week, daily, several/day. | Crude OR: 1.00 (95% CI, 0.75–1.33) | Critical |
| Women:100% | 286 | urge type (46%), | ||||||
| stress (21%), mixed (33%) | ||||||||
| 384 | ||||||||
| Brown JS et al. 2000 [7] | USA | Community-dwelling women, aged 65 years and older | Mean age: 78.5 | 6,049 | At least one falls in 1 year | UI during the past 1 year. | Adjusted b OR: | Moderate |
| Women:100% | 1,927 | At least one UI:2,818 (46.6%), | -Stress type: 1.06 (95% CI, 0.95–1.19) | |||||
| At least weekly urge type: 1,493 (24.7%), At least weekly stress type: 1,137(18.8%), Both type: 708(11.7%). | -Urge type: 1.26 (95% CI, 1.14–1.40) | |||||||
| Tromp AM et al. 2001 [16] | Netherlands | Community-dwelling adults, aged 65 years and older | Mean age: 72.6 | 1,469 | At least one falls in 1 year | Self- reported UI 24% | Adjusted c OR: 1.6 (95% CI, 1.2–2.1) | Serious |
| Men: 705 Women: 764 | 464 | |||||||
| Recurrent fall: Adjusted OR: 1.7 (95% CI, 1.2–2.5) | ||||||||
| de Rekeneire N et al. 2003 [17] | USA | Community-dwelling adults, aged 70 to 79 years | Age (70–79) Men: 1,447 | At least one falls in 1 year | Self- reported UI1,175 | Adjusted d OR: | Serious | |
| Women: 1,515 | 2,962 | 652 | - Men 1.5 (95% CI, 1.1–2.0) | |||||
| - Women: 1.5 (95% CI, 1.2–1.9) | ||||||||
| Takazawa K et al. 2005 [10] | Japan | Women in a day care service at geriatric health facility | Median age: 81 | 118 | At least one falls in 1 year | At least once a week during the past 1 year | Crude OR: 1.12 (95% CI, 0.54–2.32) | Critical |
| Women:100% | 56 | |||||||
| Stress type: 25 (49.0%), Urge type: 46(90.2%) 52 | ||||||||
| Teo JS et al. 2006 [18] | Australia | Community-dwelling women | Mean age: 79.1 | 782 | At least one falls in 1 year | Self- reported UI (regardless of amount and frequency) | Adjusted e OR: -Stress type: 1.06 (95% CI, 0.77–1.45) | Serious |
| Women:100% | 275 | |||||||
| -Urge type: 1.96 (95% CI, 1.45–2.65) | ||||||||
| Stress type: 69.4% (pure 36.8%) | ||||||||
| Urge type: 36.3% (pure 3.7%), both type: 32.6%. | ||||||||
| 73.1% | ||||||||
| Hasegawa J et al. 2010 [19] | Japan | Disabled older people who were admitted to facilities | Mean age: 82.5 | 1,082 | At least one falls | UI events during placement 180 | Adjusted f OR: 2.14 (95% CI, 1.03–2.89) | Serious |
| 264 | ||||||||
| Men: 327 | ||||||||
| Women: 755 | ||||||||
| Foley AL et al. 2012 [8] | UK | Community-dwelling adults aged 70 years or Over | Median age: 76 | 5,474 | At least one falls in 1 year | Self- reported UI | Crude OR: | Critical |
| Men: 2,245 | 1,813 | Stress type: 16.5%, urge type: 24.9% | -Stress type: 3.56 (95% CI, 3.06–4.15) | |||||
| Women: 2,917 | 26.7% | -Urge type: 2.19 (95% CI, 1.92–2.49) | ||||||
| Allain TJ et al. 2014 [20] | Malawi | Community-dwelling adults aged 60 years or Over | Mean age: 72 | 98 | At least one falls in 1 year | Self- reported UI | Crude OR: 3.27 (95% CI, 1.26–8.50) | Critical |
| Men: 29 | ||||||||
| Women: 69 | 40 | 25% | ||||||
| Huang LK et al. 2015 [21] | Taiwan | Community-dwelling adults aged 65 years or Over | Age ≥65 years | 187 | At least two falls in 1 year | UI in the past 1 year and 1week. | Adjusted g OR: 1.86 (95% CI, 0.86–4.02) | Serious |
| Men: 65 | ||||||||
| Women: 122 | 53 | 29.9% | ||||||
| Kim H et al. 2015 [22] | Japan | Community-dwelling women aged 75–84 years | Mean age: 78.5 | 1,399 | At least one falls | UI over once a week | Crude OR: 1.57 (95% CI, 1.14–2.16) | Critical |
| Women:100% | 269 | Stress type: 29.2% (76/260), Urge type: 25.0% (65/260), and Mixed type:45.8% (119/260) | ||||||
| 260 | ||||||||
| Sakushima K et al. 2016 [11] | Japan | Ambulatory patients with Parkinson’s disease in an outpatient clinic of an academic hospital | Mean age: 71.5 | 97 | At least one falls in 6 months | Mild: less than once a day, severe: once a day or more past 1 week. | Crude OR: 2.05 (95% CI, 0.88–4.73) | Critical |
| Men: 40 | 44 | |||||||
| Women: 57 | ||||||||
| Mild 27 | ||||||||
| Severe 17 | ||||||||
| Schluter PJ et al. 2018 [23] | New Zealand | Community-dwelling adults aged 65 years or Over | Mean age: 82.7 | 67,288 | At least one falls in 90 days | UI in the last 3 days | Adjusted h OR: | Moderate |
| Occasional UI: less than daily, frequently UI: daily | ||||||||
| Men: 25,257 | 27,213 | -Men | ||||||
| Women: 42,032 | Occasional UI 1.53 (95% CI, 1.43–1.64) | |||||||
| Men 34.3% | ||||||||
| Women 42.6% | ||||||||
| Frequent UI 1.69 (95% CI, 1.57–1.82) | ||||||||
| -Women | ||||||||
| Occasional UI | ||||||||
| 1.33 (95% CI, 1.26–1.39) | ||||||||
| Frequent UI 1.39 (95% CI, 1.32–1.46) | ||||||||
| Agudelo-Botero M et al. 2018 [24] | Mexico | Community-dwelling adults aged 60 years or Over | Age ≥60 years | 9,598 | At least one falls in 2 years | UI during the last 2 years | Adjusted i OR: -Occasional falls | Moderate |
| Men: 4,271 | ||||||||
| 4,466 (46%, one fall 16%, recurrent falls 30%)) | 3,021 | |||||||
| Women: 5,327 | 1.12 (95% CI, 0.98–1.28) | |||||||
| -Recurrent falls 1.52 (95% CI, 1.37–1.69) | ||||||||
| Kang J et al. 2018 [25] | Korea | Patients older than 65 who visited the geriatric clinic | Mean age: 73 | 404 | At least two falls in 6 months | UI during the last 1 month | Crude OR: 2.07 (95% CI, 1.23–3.35) | Critical |
| Men: 114 | ||||||||
| 89 | 133 | |||||||
| Women: 290 | ||||||||
| Kim HJ et al. 2018 [26] | Korea | Community-dwelling adults aged 66 years or over in nationwide cohort study | Age (66–80) Men: 20,943 | 39,854 | At least one falls in 6 months | Self- reported UI | Crude OR: 5.29 (95% CI, 4.87–5.73) | Critical |
| 5,703 | ||||||||
| Women: 18,911 | 2,802 | |||||||
| Sohn K et al. 2018 [27] | Korea | Community-dwelling women aged 65 years or over in Korean Longitudinal Study of Ageing | Age ≥65 years | 2,418 | At least one falls in 2 years | UI in the past 1 year | Crude OR: 1.29 (95% CI, 0.92–1.79) | Critical |
| Women:100% | ||||||||
| 204 | 506 | |||||||
| Singh DKA et al. 2019 [28] | Malaysia | Community-dwelling adults aged 60 years or Over | Mean age: 68.9 | 3,901 | At least one falls in 1 year | Self- reported UI | Adjusted j OR: 1.35 (95% CI, 1.07–1.69) | Serious |
| Men: 1,807 Women: 2,127 | 804 | 615 | ||||||
| Peeters G et al. 2019 [29] | Australia, Netherlands, Great Britain Ireland | Community-dwelling adults from four cohort (ALSWH, LASA, NSHD, TILDA) | Mean age: | ALSWH: 10,641 | At least one falls in 1 year | Self- reported UI | Adjusted a OR: | Serious |
| -ALSWH: 55.0–63.1. | -ALSWH: 45.6–59.0% | |||||||
| LASA: 802 | -ALSWH: 2,352 | -ALSWH: | ||||||
| -LASA: 16.7% | 1.53 (95% CI, 1.44–1.63) -LASA: | |||||||
| Women:100%-LASA: 59.7 | NSHD: 2,987 | -LASA: 201 | -NSHD: 32.2% | |||||
| -NSHD: 520 | -TILDA: 10.3–12.6% | 1.62 (95% CI, 0.95–2.78) | ||||||
| Women:51.6% | TILDA: 4663 | -TILDA: 820 | ||||||
| -NSHD: 1.68 (95% CI, | ||||||||
| -NSHD: 53.5–63.4 | ||||||||
| 1.22–2.31) -TILDA: 2.09 (95% CI, 1.75–2.49) | ||||||||
| Women:50.9–52.2% | ||||||||
| -TILDA: 56.7–58.6 | ||||||||
| Women:55.5–57.3 | ||||||||
| Giraldo-Rodriguez L et al. 2019 [30] | Mexico | Community-dwelling adults aged 50 years or Over | Aged ≥ 50 | 13,626 | At least one falls in 2 years | UI during the past 2 years | Crude OR: | Critical |
| - Men: 1.42 | ||||||||
| Men: 5,843 | 5,341 | -Men: 730 (12.5%) | (95% CI, 1.18–1.71) | |||||
| Women: 7,783 | Stress type:141(2.4%), urge type:317(5.4%), mixed type:272(4.7%) | |||||||
| -Women: 2,155 | ||||||||
| (27.7%) | ||||||||
| - Women: | ||||||||
| 1.22 (95% CI, 1.06–1.39) | ||||||||
| Stress type:731(9.4%), urge | ||||||||
| type:488(6.3%), mixed type:936(12%) | ||||||||
| Huang MH et al. 2019 [31] | USA | Men aged 65 years or over who had prostate cancer or breast cancer | 74.5(men) | 1097 | At least one falls in 1 years | UI during the past 6 months | - Men Adjusted k | Serious |
| 75.1(women) | ||||||||
| Men: 660 | 231 | 285(men) | OR: | |||||
| Women: 437 | 219 (women) | 1.69 (95% CI, 1.08–2.65) | ||||||
| -Women | ||||||||
| Crude OR: 2.27 (0.89–5.80) | ||||||||
| Abbs E et al. 2020 [32] | USA | Homeless adults aged 50 years or Over | Median age: 58 | 350 | At least one falls in the past 6 months | UI during the past 6 months 167 | Adjusted l OR: 1.40 (95% CI, 1.07–1.81) | Moderate |
| Men: 270 | ||||||||
| Women: 80 | 118 | |||||||
| Abell JG et al. 2020 [33] | UK | Community-dwelling adults aged 60 years or Over | Mean age: 69.6 | 3,783 | At least one falls in 1 year | UI during the past 12 months | Adjusted m HR:: 1.49 (95% CI, 1.14–1.95) | Moderate |
| Men: 1,791 | 315 | 574 | ||||||
| Women: 1,992 | ||||||||
| Britting S et al. 2020 [34] | Austria | Community-dwelling adults aged 75 years or over from SCOPE cohort | Median age: 79.5 | 2,256 | At least one falls in 1 year | UI during the last 1 month | Adjusted n OR: 1.33 (95% CI, 1.09–1.63) | Moderate |
| Germany | ||||||||
| Israel | Men: 1,000 | 746 | 653 | |||||
| Italy | Women: 1,256 | |||||||
| Netherlands | ||||||||
| Poland | ||||||||
| Spain | ||||||||
| Dokuzlar O et al. 2020 a [35] | Turkey | Women aged 65 years or over | Mean age: 74.4 | 682 | At least one falls in 1 year | UI during the past 12 months | Adjusted o OR: 1.61 (p value: 0.006) | Serious |
| Women:100% | 215 | 55.4% | ||||||
| Dokuzlar O et al. 2020 b [36] | Turkey | Men aged 65 years or over | Mean age: 75.0 | 334 | At least one falls in 1 year | UI during the past 12 months | Adjusted o OR: 2.468 (p-value: 0.001) | Serious |
| Men:100% | 85 | 33.2% | ||||||
| Lee K et al. 2020 [37] | USA | Community-dwelling adults aged 65 years or over | Mean age: 70.4 | 17,712 | At least one falls in 2 year | UI during the past 12 months | Adjusted p OR: 1.96 (95% CI, 1.59–2.40) | Serious |
| 4,779 | 3,340 | |||||||
| Men: 7,626 | ||||||||
| Women: 10,086 | ||||||||
| Magnuszewski L et al. 2020 [38] | Poland | Patients admitted to the department of geriatrics | Mean age: 85 | 358 | At least one falls in 1 year | Self- reported UI | Adjusted q OR: 1.37 (95% CI, 0.75–2.49) | Serious |
| Men:80 | 146 | |||||||
| Women: 278 | 157 | |||||||
| Moon S et al. 2020 [2] | Korea | Community-dwelling women aged 65 years or over | Mean age: 74.5 | 6,134 | At least one falls in 1 year | Self- reported UI | Adjusted r OR: 1.33(95% CI, 1.00−1.76) | Moderate |
| 281 | ||||||||
| Women:100% | 1,152 | |||||||
| Savas S et al. 2020 [39] | Turkey | Community-dwelling adult | Mean age: 65 | 1176 | At least one falls in 1 year | Self- reported UI | Crude OR: | Critical |
| Men:592 | 346 | 1.21 (95% CI, 0.79–1.87) | ||||||
| Women: 584 | 276 | |||||||
| Tsai YJ et al. 2020 [40] | Taiwan | Community-dwelling adults aged 65 years or over (NHIS 2005, 2009, 2013) | Men:4,142 | 8,822 | At least one falls in 1 year | Self- reported UI | Adjusted s OR: 1.09 (0.80–1.49), 1.29 (0.90–1.84), 1.42 (1.04–1.94) | Serious |
| Women: 4,680 | 1,573 | |||||||
| 1,672 | ||||||||
| Cesari M et al.2002 [42] | Italy | Community-dwelling adults admitted to national home care program | Mean age: 77.2 | 5,570 | At least one falls in 90 days | Self- reported UI | Adjusted t OR: 1.06 (0.93–1.20), | Serious |
| 1,997 | 1,744 | |||||||
| Men: 2,290 | ||||||||
| Women: 3,280 | ||||||||
| Hedman AM et al. 2013 [43] | Sweden | Community-dwelling adults aged 75 years or over | Median age: 81 | 1,243 | At least one falls in 1 year | Self- reported UI 1,139 | Adjusted u OR: 1.53 (1.23–1.91), | Serious |
| Men: 471 | 434 | 425(men) | ||||||
| Women: 772 | 714(women) | - Men: 1.67 (1.13–2.47), | ||||||
| - Women: 1.53 (1.16–2.00) | ||||||||
| Moreira MD et al. 2007 [46] | Brazil | Community-dwelling adults aged 60 years or over | Mean age: 79 | 490 | At least one falls in 1 year | Self- reported UI 86 | p <0,025 | Critical |
| Men: 116 | ||||||||
| 137 | ||||||||
| Women: 374 | ||||||||
| Stenhagen M et al. 2013 [44] | Sweden | Community-dwelling adults aged 60 years or over | Men: 264 | 1,736 | At least one falls in 6 months | Self- reported UI | Crude OR: 1.89 (1.38–2.58) | Serious |
| Women: 394 (3-year follow up) | 555 (3-year follow up) | 267 | ||||||
| 106(3-year follow up) | ||||||||
| 1,542(6-year follow up) | With UI: 267 (67 with falls) | |||||||
| Men: 784 | 205(6-year follow up) | |||||||
| Women: 963 (6-year follow up) | ||||||||
| Without UI: 1453 (219 with falls) | ||||||||
| Adjusted a OR: 1.31 (0.94–1.82) | ||||||||
| van Helden S et al. 2007 [45] | Netherland | Patients older than 50 who visited the geriatric clinic | Mean age: 67.1 | 277 | At least one falls in 3 months | Self- reported UI | Crude OR: 2.07 (0.98–4.41) | Critical |
| Men: 77 | 42 | 50 | ||||||
| Women: 200 |
OR, odds ratios; HR, hazard ratios; UI, urinary incontinence; CI, confidence intervals; ALSWH, The Australian Longitudinal Study on Women’s Health; LASA, The Longitudinal Ageing Study Amsterdam; NSHD, The MRC National Survey of Health and Development; TILDA, The Irish Longitudinal Study on Ageing.
a adjusted for age and sex,
b adjusted for age, living situation, overall frailty, number of falls in the previous year, whether she walked for exercise, alcohol and caffeine consumption, medical history, medication use, grip strength, gait speed, whether she used her arms to stand from chair, and performance of 10-second tandem balance.
c adjusted for age, gender, educational level, urbanization level, chronic diseases, physical function, level of activity and mobility, previous falls, fear of falling
d adjusted for age, race, study site, and body mass index.
e adjusted for age, central nervous system drug and cardiovascular system drugs.
f adjusted for age, gender, physical function, behavioral symptom, and medication use.
g adjusted for gender, depressive mood, and activities involving lower limb.
h adjusted for: age, ethnicity, marital status, living arrangements, body mass index, cognitive performance, dementia, congestive heart failure, Chronic obstructive pulmonary disease, depression, diabetes mellitus, alcohol consumption, smoking status, hearing status, vision status, fatigue, mobility, stability, dizziness, wandering, season, bisphosphonates, vitamin D, and calcium.
i adjusted for sociodemographic, medical and functional covariables.
j adjusted for age, sex, educational level and ethnicity.
k adjusted for age at prostate cancer diagnosis, time since cancer diagnosis, history of falls, marital status, physical summary score of Veterans RAND 12-Item Health Survey.
l adjusted for age, sex, race, stroke, Activities of Daily Living (ADL) impairment, use of an assistive device., marijuana use, opioid use, history of physical assault, any nights spent in unsheltered settings.
m adjusted for age, sex, chronic conditions (coronary heart disease, diabetes, Stroke, Arthritis, Osteoporosis, Parkinson’s Disease), BMI, Smoking status, Alcohol consumption, The Short Physical Performance Battery (SPPB), and history of severe fall.
n adjusted for age, gender, geriatric depression score (GDS), chronic kidney disease (CKD), instrumental activities of daily living (IADL) score and Euro-Qol 5D Score.
o adjusted for age, education level, and living environment.
p adjusted for age, sex, race/ethnicity, and spouse/partner status.
q adjusted for age, multimorbidity, chronic diseases (cardiac heart failure, peripheral arterial disease, history of stroke/ transient ischemic attack, Parkinson’s disease, and chronic osteoarthritis, Performance Oriented Mobility Assessment, Barthel Index, IADL score, gait speed, Clinical Frailty Scale, Mini Nutritional Assessment Short Form, albumin value, vitamin B12 level and taking certain medications (quetiapine, vitamin D, diuretics, benzodiazepines and selective serotonin reuptake inhibitor).
r adjusted for age, smoking status, alcohol consumption, body mass index, hypertension, dyslipidemia, and diabetes mellitus, cognitive impairment, ADL and IADL disability, visual and hearing impairment, and lower limb weakness.
s adjusted for age, sex, developing difficulty in performing ADLs or IADLs, use of sleeping pills, vision, comorbidities, depressive symptoms, and frequency of exercise.
t adjusted for age, gender, activities of daily living impairment, foot problems, gait problems, fear of falling, visual impairment, wandering, depression, parkinsonism, and environmental hazards.
u Poor self-rated health, Pain in neck and shoulders, Back pain, sciatica or hip pain, Pain in hands, elbows, legs or knees, Headache or migraine, Anxiety, Tiredness, Sleeping disorders, Tinnitus, Recurring stomach problems, Overweight/Underweight.