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Tricco A, Thomas S, Veroniki A, et al. Comparisons of interventions for preventing falls in older adults: A systematic review and meta-analysis JAMA. 2017;318:1687-1699.
What types of fall prevention strategies are effective in reducing falls that result in injuries among older adults over 65 years of age?
As the worldwide population ages, the incidence of falls is expected to increase. Falls are costly to health care systems, and patients who may experience reduced quality of life, increased anxiety and depression, and serious injury or death. It is presently unclear what the key features are for an effective fall prevention program, and an analysis ranking available fall prevention strategies and their combinations has not been done.
This is a systematic review of 283 randomized controlled trials (159,910 participants) published between 1990 and 2017, with a meta-analysis.
In older adults over the age of 65, the following fall prevention strategies lowered the risk of falls that led to injuries, compared to usual care:
Meanwhile, the following fall prevention strategies lowered the risk of older adults experiencing a fall, compared to usual care:
Lastly, combined osteoporosis treatment, calcium supplementation, and vitamin D supplementation lowered the risk of fracture and hip fracture, compared to usual care. There was no effect seen on fall-related hospitalizations and emergency department and outpatient doctor visits when comparing different prevention strategies and usual care. However, combined exercise, environmental assessment and modification, and multifactorial assessment and treatment increased the risk of falls that led to injury, while combined exercise, patient-level quality improvement strategies, and social engagement increased the risk of experiencing a fall.
Exercise on its own, as well as with various combinations of falls prevention strategies including: vision test and treatment, environmental checks and changes, clinical quality improvement, multifactorial assessment and treatment, calcium supplementation, and vitamin D supplementation can reduce the risk of falls leading to injuries. Combined exercise and vision assessment and treatment may be most beneficial.
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