ABSTRACT NUMBER: ESOC2026A241 RISK FACTORS FOR FALLS AND RECURRENT FALLS IN OLDER STROKE SURVIVORS

Abstract Background and aims Falls are a common and serious complication after stroke in older adults, yet a comprehensive, stroke-specific synthesis of fall risk factors is lacking. To synthesise prospective evidence and identify risk factors for falls and recurrent falls in older stroke survivors. Methods Two reviewers independently screened studies and assessed methodological quality. Pooled effects were calculated as odds ratios (ORs) with 95% confidence intervals (CIs) using random-effects models. Databases searched included PubMed, Cochrane Library, Embase, Web of Science, Scopus, PsycINFO and CINAHL from inception to 4 January 2025. Results Falls in older stroke survivors were associated with impaired mobility (OR 2.64, 95% CI 1.48-4.71), impaired balance (OR 2.09, 95% CI 0.89-4.87), motor impairment (OR 2.00, 95% CI 1.33-3.01), self-care disability (OR 1.98, 95% CI 1.20-3.28), walking aid use (OR 2.27, 95% CI 1.49-3.46), depression (OR 1.56, 95% CI 1.15-2.12), sedative or psychotropic use (OR 3.32, 95% CI 1.40-7.92), and prior falls (OR 2.06, 95% CI 1.24-3.43), while cognitive impairment (OR 1.10, 95% CI 0.62-1.95) and visual impairment (OR 1.40, 95% CI 0.85-2.28) were non-significant; for recurrent falls, prior falls were strongly predictive (OR 38.52, 95% CI 11.65-127.35), whereas motor impairment (OR 2.16, 95% CI 1.00-4.67) and reduced balance (OR 5.65, 95% CI 0.90-35.61) were non-significant. Conclusions Falls are a major concern in older stroke survivors. Key risk factors include deficits in balance and mobility, use of walking aids, depression and medication use, with previous falls strongly predicting recurrence. Future work should elucidate mechanisms and develop targeted, stroke-specific fall prevention strategies. Conflict of interest Qi Zhang. nothing to disclose