Multifactorial and multiple component interventions for preventing falls in older people living in the community

Hopewell, Sally; Adedire, Olubusola; Copsey, Bethan; Sherrington, Catherine; Clemson, Lindy; Close, Jacqueline C.T.; Lamb, Sarah E

doi:10.1002/14651858.cd012221

Cited by 91 publications

(146 citation statements)

References 21 publications

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“…We identified five guidelines and six systematic reviews [5,[14][15][16][17][18] that addressed fall interventions in the outpatient setting, and three guidelines and three systematic [15,19,20] reviews related to fall interventions in the inpatient setting (some overlap exists). An overview of these guidelines and their level of evidence can be found in Supplementary Tables 1 and 2.…”

Section: Fall Interventionsmentioning

confidence: 99%

Falls in older patients with cancer: Nursing and Allied Health Group of International Society of Geriatric Oncology review paper

Sattar

Kenis²,

Haase

et al. 2020

Journal of Geriatric Oncology

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Background: Falls are a major health issue in older adults and are of greater concern among those with cancer due to effects of cancer and its treatments. This paper provides an overview of current literature on fall screening/ assessment and interventions and a succinct summary of recommendations for oncology nurses to support this vulnerable population. Methods: A comprehensive search for literature reviews on falls was conducted in Medline and CINAHL. A comprehensive Internet search was also performed for known guidelines on fall prevention and/or management published within the past 10 years. Search results were compared, contrasted, and summarized to develop clinical recommendations for nurses working with older adults with cancer. Levels of evidence were reported based on the Oxford Centre for Evidence-based Medicine. Results: Six guidelines and 17 systematic reviews were identified. Having a history of falls was the most commonly identified fall risk factor/predictor. Multifactorial intervention and exercise appear to be the most commonly recommended. No fall assessment tools were consistently recommended as a reliable means of identifying those at risk for falls. Conclusion: Assessing older patients for falls and fall risks is an important first step to identify those who may require further follow-up and intervention. Oncology nurses play a key role in optimizing health outcomes of older adults with cancer-through the use of evidence-based information, such as presented in this publication-and have the capacity to help reduce fall risks during and after treatment through information provision, advocacy, support, and promotion of physical activity.

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Section: Fall Interventionsmentioning

confidence: 99%

Falls in older patients with cancer: Nursing and Allied Health Group of International Society of Geriatric Oncology review paper

Sattar

Kenis²,

Haase

et al. 2020

Journal of Geriatric Oncology

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“…A common cause of fracture in osteoporosis subjects is a fall from a standing height or less; 90% of hip fractures result from a fall . Therefore, falls risk reduction is an important component of primary and secondary fragility fracture prevention strategies, usually delivered via multidisciplinary approaches . Such approaches include falls risk assessment, exercises, medication review (that includes an assessment of any association with falls for each medication type being administered, as well as dose reductions or switching to alternatives that may be less likely to result in falls, if applicable), and vitamin D supplementation (with or without calcium) .…”

Section: Introductionmentioning

confidence: 99%

A Pooled Analysis of Fall Incidence From Placebo-Controlled Trials of Denosumab

Chotiyarnwong

McCloskey

Eastell

et al. 2020

Journal of Bone and Mineral Research

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Recent studies suggest that the RANK/RANKL system impacts muscle function and/or mass. In the pivotal placebo‐controlled fracture trial of the RANKL inhibitor denosumab in women with postmenopausal osteoporosis, treatment was associated with a lower incidence of non‐fracture‐related falls (p = 0.02). This ad hoc exploratory analysis pooled data from five placebo‐controlled trials of denosumab to determine consistency across trials, if any, of the reduction of fall incidence. The analysis included trials in women with postmenopausal osteoporosis and low bone mass, men with osteoporosis, women receiving adjuvant aromatase inhibitors for breast cancer, and men receiving androgen deprivation therapy for prostate cancer. The analysis was stratified by trial, and only included data from the placebo‐controlled period of each trial. A time‐to‐event analysis of first fall and exposure‐adjusted subject incidence rates of falls were analyzed. Falls were reported and captured as adverse events. The analysis comprised 10,036 individuals; 5030 received denosumab 60 mg subcutaneously once every 6 months for 12 to 36 months and 5006 received placebo. Kaplan–Meier estimates showed an occurrence of falls in 6.5% of subjects in the placebo group compared with 5.2% of subjects in the denosumab group (hazard ratio = 0.79; 95% confidence interval 0.66–0.93; p = 0.0061). Heterogeneity in study designs did not permit overall assessment of association with fracture outcomes. In conclusion, denosumab may reduce the risk of falls in addition to its established fracture risk reduction by reducing bone resorption and increasing bone mass. These observations require further exploration and confirmation in studies with muscle function or falls as the primary outcome. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research..

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“…Falling is common, and leads to fall-related injuries, which in turn result in a significant cause of morbidity and mortality in the elderly. [1][2][3] About one-third of older people, over 65 years of age, in communities have at least one experience of falling annually. 1,[4][5][6] Fall-related injuries consist of both minor and major injuries, with minor injuries including: bruising, lacerations, abrasions, sprains and strains.…”

Section: Introductionmentioning

confidence: 99%

Comparative Effect of a Balance Training Program and Core Stabilization Program on Factors Related to the Prevention of Falling in Healthy Middle-Aged Individuals: A Double-Blind Randomized Controlled Clinical Trial

Sonthikul

Kaewmunee

Sriwannawit

et al. 2019

J Health Sci Med Res

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Objectives: The aim of this study to compare the effectiveness of the balance training program (BTP), and the corestabilization program (CSP), on dynamic balance in healthy middle-aged individuals.Material and Methods: This study was a single-blind randomized controlled trial design. Forty-two healthy middle-aged participants were randomly assigned to the BTP group (n=21), or the CSP group (n=21). Participants in both groups received an intervention program (balance training or core stabilization) 3 times a week, for 60 minutes, over 6 weeks. The primary outcome was the dynamic balance measured by the timed up and go test. The other outcomes were: core muscle endurance, muscle strength of the lower extremities, the flexibility of the lower back and hamstring muscles, and gait variables. The measurements included: the prone bridge endurance test, 5 times sit to stand test, sit and reach test and a wireless movement monitoring inertial sensor system, respectively. All outcomes were measured at baseline, and then after 6 weeks. The data were analyzed by the Independent Sample t-test between groups, and the paired t-test within either group.Results: After 6 weeks, there was no statistically significant difference between the groups in either dynamic balance,or other variables, however, a statistically significant difference was found in core muscle endurance (p-value=0.003). In so saying, the BTP group, statistically significant improvements were found only in core muscle endurance, the flexibility of the lower back and hamstring muscles, and gait variables from pre- to post-test. Moreover, in the CSP group, there was a statistically significant difference from pre- to post-test in all measured outcomes. Conclusion: The Core stabilization program is not superior to a balance training program, for the improvement of dynamic balance. Although, after 6 weeks of training, the study found that the Core stabilization program was effective for improving dynamic balance. This finding may point out that the Core stabilization program helps improve balance in a middle-aged person

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Multifactorial and multiple component interventions for preventing falls in older people living in the community

Abstract: Multifactorial and multiple component interventions for preventing falls in older people living in the community.

Cited by 91 publications

References 21 publications

Falls in older patients with cancer: Nursing and Allied Health Group of International Society of Geriatric Oncology review paper

Falls in older patients with cancer: Nursing and Allied Health Group of International Society of Geriatric Oncology review paper

A Pooled Analysis of Fall Incidence From Placebo-Controlled Trials of Denosumab

Comparative Effect of a Balance Training Program and Core Stabilization Program on Factors Related to the Prevention of Falling in Healthy Middle-Aged Individuals: A Double-Blind Randomized Controlled Clinical Trial

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