Evidence-Based Practice Project. Thirty-three articles were analyzed and synthesized. The strongest results were found for multifactorial programs that included home evaluations and home modifications, physical activity or exercise, education, vision and medication checks, or assistive technology to prevent falls. Positive outcomes included a decreased rate of functional decline, a decrease in fear of falling, and an increase in physical factors such as balance and strength. The strength of the evidence for physical activity and home modification programs provided individually was moderate. Implications for practice, education, and research are also discussed. T his systematic review was part of a larger project that reviewed research studies examining the effect of occupation-and activity-based interventions designed to promote and support productive aging. The objective of this systematic review was to synthesize existing literature to answer the following focused question: "What is the evidence for the effect of home modification and fall prevention programs on the performance of community-dwelling older adults?" We reviewed the effect of home modification as both a separate intervention and a component of several fall prevention programs. Fall prevention programs that studied the effects of physical activity interventions on strength, endurance, or balance, such as exercise-based or tai chi intervention programs, were also included in this review.
Screening tools that require cognitive resources such as gait speed appear to have significant relationships with performance of EF for those who screen positive for MCI. This information could be used clinically to identify older adults with cognitive limitations, which could put them at higher risk for falling.
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