Fall-prevention strategies that include multiple components are effective at reducing fall rates and the total number of falls among older adults

Goodwin VA, Abbott RA, Whear R, et al. Multiple component interventions for preventing falls and fall-related injuries among older people: Systematic review and meta-analysis, BMC Geriatrics, 2014, 14:15.

Review question

What is the effect of strategies with several components on fall rates and number of falls, as well as on fall-related injuries among older adults?

Background

Falls are a common problem affecting older adults, with a third of those aged 65 and over and half of those aged 85 and over, experiencing at least one fall each year.

There are several negative consequences associated with falls including disability, reduced quality of life, and financial costs (both to individuals and society).

Fall-prevention strategies can include single components (e.g. exercise), multiple components tailored to individual needs (e.g. a combination of approaches determined by an assessment of individual risks), or multiple components that are standard and delivered to a number of individuals (e.g. exercise plus vitamin supplements).

Little is known about the effectiveness of fall-prevention strategies that include multiple components, whether tailored for individuals or standardized.

How the review was done

Several electronic databases were searched for peer-reviewed studies published up to August 2013.

Studies were included if they compared multiple-component fall-prevention strategies to reduce fall rates, total number of falls, or fall-related injuries in people aged 60 years or older.

A total of 3,691 documents were identified in searches, and 17 studies were deemed eligible and included in the review.

The review was funded by the National Institute for Health Research Collaboration for Applied Health Research and Care in the United Kingdom.

What the researchers found

Overall, strategies with multiple components that are not tailored to the specific needs of older adults are effective at reducing the total number of older adults who fall, and fall rates. However, it remains unclear if these strategies are effective in preventing fall-related injuries.

Fall-prevention strategies with multiple components can be less resource intensive than strategies that are tailored for individuals, since they do not require healthcare providers to undertake an in-depth assessment of risk factors for each individual.

Conclusion

Older adults should receive strategies with multiple components from healthcare providers, without the need for individualized risk assessment, to prevent falls.