Prevention of falls in the elderly: A review

Scandinavian Journal of Public Health

Volumn 41, Issue 5, 2013, Pages 442-454

  Karlsson, Magnus K ^a   Vonschewelov, Thord ^a   Karlsson, Caroline ^a   CÃster, Maria ^a   Rosengen, BjÃrn E ^a  

^a LUND UNIVERSITY HOSPITAL   (Sweden)

Author keywords

Elderly; epidemiology; falls; fractures; prevention; randomized controlled trials

Indexed keywords

AGED; EPIDEMIOLOGY; FALLING; FALLS; FRACTURE; HEALTH CARE QUALITY; HUMAN; PREVENTION; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; RISK FACTOR;

ELDERLY; EPIDEMIOLOGY; FALLS; FRACTURES; PREVENTION; RANDOMIZED CONTROLLED TRIALS;

ACCIDENTAL FALLS; AGED; HUMANS; PROGRAM EVALUATION; RANDOMIZED CONTROLLED TRIALS AS TOPIC; RISK FACTORS;

EID: 84878515480     PISSN: 14034948     EISSN: 16511905     Source Type: Journal    
DOI: 10.1177/1403494813483215     Document Type: Article

References (118)

1. Tinetti M.E. Speechley M. Ginter S.F. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988;319:1701–7.
2. Kannus P. Sievanen H. Palvanen M. et al. Prevention of falls and consequent injuries in elderly people. Lancet 2005;366:1885–93.
3. Tinetti M.E. Liu W.L. Ginter S.F. Mechanical restraint use and fall-related injuries among residents of skilled nursing facilities. Ann Intern Med 1992;116:369–74.
4. Tinetti M.E. Doucette J. Claus E. et al. Risk factors for serious injury during falls by older persons in the community. J Am Geriatr Soc 1995;43:1214–21.
5. Fingerhut L. Warner M. Injury chartbook, Health, United States, 1996–1997. Maryland: Hyattsville, 1997.
6. Stevens J.A. Corso P.S. Finkelstein E.A. et al. The costs of fatal and non-fatal falls among older adults. Inj Prev 2006;12:290–5.
7. Rice D. MacKenzie E. and Associates. Cost of injury in the United States: a report to congress. San Francisco: University of California, 1989.
8. Melton L.J. 3rd Riggs B.L. Risk factors for injury after a fall. Clin Geriatr Med 1985;1:525–39.
9. Kannus P. Niemi S. Parkkari J. et al. Nationwide decline in incidence of hip fracture. J Bone Miner Res 2006;21: 1836–8.
10. Rosengren B.E. Ahlborg H.G. Mellstrom D. et al. Secular trends in Swedish hip fractures 1987–2002: birth cohort and period effects. Epidemiology 2012;23:623–30.
11. Cooper C. Campion G. Melton L.J. 3rd. Hip fractures in the elderly: a world-wide projection. Osteoporos Int 1992;2:285–9.
12. Jarvinen T.L. Sievanen H. Khan K.M. et al. Shifting the focus in fracture prevention from osteoporosis to falls. BMJ 2008;336:124–6.
13. Cummings S.R. Nevitt M.C. Browner W.S. et al. Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group. N Engl J Med 1995;332: 767–73.
14. Cameron I.D. Murray G.R. Gillespie L.D. et al. Interventions for preventing falls in older people in nursing care facilities and hospitals. Cochrane Database of Systematic Reviews 2010:CD005465.
15. Gillespie L.D. Robertson M.C. Gillespie W.J. et al. Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews 2009:CD007146.
16. Perry B.C. Falls among the elderly: a review of the methods and conclusions of epidemiologic studies. J Am Geriatr Soc 1982;30:367–71.
17. Davison J. Bond J. Dawson P. et al. Patients with recurrent falls attending Accident & Emergency benefit from multifactorial intervention–a randomised controlled trial. Age Ageing 2005;34:162–8.
18. Province M.A. Hadley E.C. Hornbrook M.C. et al. The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials. Frailty and injuries: cooperative studies of intervention techniques. Jama 1995;273:1341–7.
19. Tinetti M.E. McAvay G. Claus E. Does multiple risk factor reduction explain the reduction in fall rate in the Yale FICSIT Trial? Frailty and injuries cooperative studies of intervention techniques. Am J Epidemiol 1996;144: 389–99.
20. Close J. Ellis M. Hooper R. et al. Prevention of falls in the elderly trial (PROFET): a randomised controlled trial. Lancet 1999;353:93–97.
21. Gillespie L.D. Robertson M.C. Gillespie W.J. et al. Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews 2012;9:CD007146.
22. McClure R. Turner C. Peel N. et al. Population-based interventions for the prevention of fall-related injuries in older people. Cochrane Database of Systematic Reviews 2005:CD004441.
23. Karinkanta S. Piirtola M. Sievanen H. et al. Physical therapy approaches to reduce fall and fracture risk among older adults. Nat Rev Endocrinol 2010;6:396–407.
24. Lyons R.A. John A. Brophy S. et al. Modification of the home environment for the reduction of injuries. Cochrane Database of Systematic Reviews 2006:CD003600.
25. Oliver D. Connelly J.B. Victor C.R. et al. Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: systematic review and meta-analyses. BMJ 2007;334:82.
26. Sherrington C. Whitney J.C. Lord S.R. et al. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc 2008;56:2234–43.
27. Liu C.J. Latham N.K. Progressive resistance strength training for improving physical function in older adults. Cochrane Database of Systematic Reviews 2009:CD002759.
28. Campbell A.J. Robertson M.C. Gardner M.M. et al. Falls prevention over 2 years: a randomized controlled trial in women 80 years and older. Age Ageing 1999;28:513–8.
29. Gardner M.M. Robertson M.C. Campbell A.J. Exercise in preventing falls and fall related injuries in older people: a review of randomised controlled trials. Br J Sports Med 2000;34:7–17.
30. Gillespie L.D. Gillespie W.J. Robertson M.C. et al. Interventions for preventing falls in elderly people. Cochrane Database of Systematic Reviews 2003:CD000340.
31. Karinkanta S. Heinonen A. Sievanen H. et al. A multi-component exercise regimen to prevent functional decline and bone fragility in home-dwelling elderly women: randomized, controlled trial. Osteoporos Int 2007;18:453–62.
32. Barnett A. Smith B. Lord S.R. et al. Community-based group exercise improves balance and reduces falls in at-risk older people: a randomised controlled trial. Age Ageing 2003;32:407–14.
33. Ballard J.E. McFarland C. Wallace L.S. et al. The effect of 15 weeks of exercise on balance, leg strength, and reduction in falls in 40 women aged 65 to 89 years. J Am Med Womens Assoc 2004;59:255–61.
34. Buchner D.M. Cress M.E. de Lateur B.J. et al. The effect of strength and endurance training on gait, balance, fall risk, and health services use in community-living older adults. J Gerontol A Biol Sci Med Sci 1997;52:M218–M224.
35. Bunout D. Barrera G. Avendano M. et al. Results of a community-based weight-bearing resistance training programme for healthy Chilean elderly subjects. Age Ageing 2005;34:80–83.
36. Carter N.D. Khan K.M. McKay H.A. et al. Community-based exercise program reduces risk factors for falls in 65- to 75-year-old women with osteoporosis: randomized controlled trial. CMAJ 2002;167:997–1004.
37. Korpelainen R. Keinanen-Kiukaanniemi S. Heikkinen J. et al. Effect of impact exercise on bone mineral density in elderly women with low BMD: a population-based randomized controlled 30-month intervention. Osteoporos Int 2006;17:109–18.
38. Lord S.R. Castell S. Corcoran J. et al. The effect of group exercise on physical functioning and falls in frail older people living in retirement villages: a randomized, controlled trial. J Am Geriatr Soc 2003;51:1685–92.
39. Lord S.R. Ward J.A. Williams P. et al. The effect of a 12-month exercise trial on balance, strength, and falls in older women: a randomized controlled trial. J Am Geriatr Soc 1995;43:1198–206.
40. Means K.M. Rodell D.E. O'Sullivan P.S. Balance, mobility, and falls among community-dwelling elderly persons: effects of a rehabilitation exercise program. Am J Phys Med Rehabil 2005;84:238–50.
41. Luukinen H. Lehtola S. Jokelainen J. et al. Pragmatic exercise-oriented prevention of falls among the elderly: a population-based, randomized, controlled trial. Prev Med 2007;44:265–71.
42. Rubenstein L.Z. Josephson K.R. Trueblood P.R. et al. Effects of a group exercise program on strength, mobility, and falls among fall-prone elderly men. J Gerontol A Biol Sci Med Sci 2000;55:M317–M321.
43. Skelton D. Dinan S. Campbell M. et al. Tailored group exercise (Falls Management Exercise – FaME) reduces falls in community-dwelling older frequent fallers (an RCT). Age Ageing 2005;34:636–9.
44. Campbell A.J. Robertson M.C. Gardner M.M. et al. Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women. BMJ 1997;315:1065–9.
45. Weerdesteyn V. Rijken H. Geurts A.C. et al. A five-week exercise program can reduce falls and improve obstacle avoidance in the elderly. Gerontology 2006;52:131–41.
46. Lin M.R. Wolf S.L. Hwang H.F. et al. A randomized, controlled trial of fall prevention programs and quality of life in older fallers. J Am Geriatr Soc 2007;55:499–506.
47. Suzuki T. Kim H. Yoshida H. et al. Randomized controlled trial of exercise intervention for the prevention of falls in community-dwelling elderly Japanese women. J Bone Miner Metab 2004;22:602–11.
48. Robertson M.C. Devlin N. Scuffham P. et al. Economic evaluation of a community based exercise programme to prevent falls. J Epidemiol Community Health 2001;55:600–6.
49. Li F. Harmer P. Fisher K.J. et al. Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci 2005;60:187–94.
50. Wolf S.L. Barnhart H.X. Ellison G.L. et al. The effect of Tai Chi Quan and computerized balance training on postural stability in older subjects. Atlanta FICSIT Group. Frailty and injuries: cooperative studies on intervention techniques. Phys Ther 1997;77:371–81; discussion 82–84.
51. Wolf S.L. Sattin R.W. Kutner M. et al. Intense tai chi exercise training and fall occurrences in older, transitionally frail adults: a randomized, controlled trial. J Am Geriatr Soc 2003;51:1693–701.
52. Cornillon E. Blanchon M.A. Ramboatsisetraina P. et al. [Effectiveness of falls prevention strategies for elderly subjects who live in the community with performance assessment of physical activities (before-after)]. Ann Readapt Med Phys 2002;45:493–504.
53. McMurdo M.E. Mole P.A. Paterson C.R. Controlled trial of weight bearing exercise in older women in relation to bone density and falls. BMJ 1997;314:569.
54. Liu-Ambrose T. Khan K.M. Eng J.J. et al. Balance confidence improves with resistance or agility training. Increase is not correlated with objective changes in fall risk and physical abilities. Gerontology 2004;50:373–82.
55. Shumway-Cook A. Gruber W. Baldwin M. et al. The effect of multidimensional exercises on balance, mobility, and fall risk in community-dwelling older adults. Phys Ther 1997;77:46–57.
56. Wolfson L. Whipple R. Derby C. et al. Balance and strength training in older adults: intervention gains and Tai Chi maintenance. J Am Geriatr Soc 1996;44:498–506.
57. Piirtola M. Isoaho R. Kivela S.L. [Physical exercise is an advantageous and effective way to prevent falls and injuries due to falls]. Duodecim 2003;119:599–604.
58. Petridou E.T. Manti E.G. Ntinapogias A.G. et al. What works better for community-dwelling older people at risk to fall? A meta-analysis of multifactorial versus physical exercise-alone interventions. J Aging Health 2009;21:713–29.
59. Davis J.C. Robertson M.C. Ashe M.C. et al. Does a home-based strength and balance programme in people aged > or =80 years provide the best value for money to prevent falls? A systematic review of economic evaluations of falls prevention interventions. Br J Sports Med 2010;44:80–89.
60. Frick K.D. Kung J.Y. Parrish J.M. et al. Evaluating the cost-effectiveness of fall prevention programs that reduce fall-related hip fractures in older adults. J Am Geriatr Soc 2010;58:136–41.
61. Voukelatos A. Cumming R.G. Lord S.R. et al. A randomized, controlled trial of tai chi for the prevention of falls: the Central Sydney tai chi trial. J Am Geriatr Soc 2007;55:1185–91.
62. Pereira M.A. Kriska A.M. Day R.D. et al. A randomized walking trial in postmenopausal women: effects on physical activity and health 10 years later. Arch Intern Med 1998;158:1695–701.
63. Resnick B. Testing the effect of the WALC intervention on exercise adherence in older adults. J Gerontol Nurs 2002;28:40–49.
64. Baker M.K. Atlantis E. Fiatarone Singh M.A. Multi-modal exercise programs for older adults. Age Ageing 2007;36:375–81.
65. Mulrow C.D. Gerety M.B. Kanten D. et al. A randomized trial of physical rehabilitation for very frail nursing home residents. JAMA 1994;271:519–24.
66. Faber M.J. Bosscher R.J. Chin APMJ et al. Effects of exercise programs on falls and mobility in frail and pre-frail older adults: A multicenter randomized controlled trial. Arch Phys Med Rehabil 2006;87:885–96.
67. Rosendahl E. Gustafson Y. Nordin E. et al. A randomized controlled trial of fall prevention by a high-intensity functional exercise program for older people living in residential care facilities. Aging Clin Exp Res 2008;20:67–75.
68. Schoenfelder D.P. A fall prevention program for elderly individuals. Exercise in long-term care settings. J Gerontol Nurs 2000;26:43–51.
69. Sakamoto K. Nakamura T. Hagino H. et al. Effects of unipedal standing balance exercise on the prevention of falls and hip fracture among clinically defined high-risk elderly individuals: a randomized controlled trial. J Orthop Sci 2006;11:467–72.
70. Shimada H. Obuchi S. Furuna T. et al. New intervention program for preventing falls among frail elderly people: the effects of perturbed walking exercise using a bilateral separated treadmill. Am J Phys Med Rehabil 2004;83:493–9.
71. Sihvonen S. Sipila S. Taskinen S. et al. Fall incidence in frail older women after individualized visual feedback-based balance training. Gerontology 2004;50:411–6.
72. Latham N.K. Anderson C.S. Lee A. et al. A randomized, controlled trial of quadriceps resistance exercise and vitamin D in frail older people: the Frailty Interventions Trial in Elderly Subjects (FITNESS). J Am Geriatr Soc 2003;51:291–9.
73. Bischoff-Ferrari H.A. Orav E.J. Dawson-Hughes B. Effect of cholecalciferol plus calcium on falling in ambulatory older men and women: a 3-year randomized controlled trial. Arch Intern Med 2006;166:424–30.
74. Porthouse J. Cockayne S. King C. et al. Randomised controlled trial of calcium and supplementation with cholecalciferol (vitamin D3) for prevention of fractures in primary care. BMJ 2005;330:1003.
75. Dhesi J.K. Jackson S.H. Bearne L.M. et al. Vitamin D supplementation improves neuromuscular function in older people who fall. Age Ageing 2004;33:589–95.
76. Pfeifer M. Begerow B. Minne H.W. et al. Effects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. J Bone Miner Res 2000;15:1113–8.
77. Gallagher J.C. Fowler S.E. Detter J.R. et al. Combination treatment with estrogen and calcitriol in the prevention of age-related bone loss. J Clin Endocrinol Metab 2001;86:3618–28.
78. Pit S.W. Byles J.E. Henry D.A. et al. A quality use of medicines program for general practitioners and older people: a cluster randomised controlled trial. Med J Aust 2007;187:23–30.
79. Kenny R.A. Richardson D.A. Steen N. et al. Carotid sinus syndrome: a modifiable risk factor for nonaccidental falls in older adults (SAFE PACE). J Am Coll Cardiol 2001;38:1491–6.
80. Ryan T.J. Large cardiac registries: the path to higher quality and lower cost in our healthcare system. Circulation 2010;121:2612–4.
81. Parry M.J. Watt-Watson J. Hodnett E. et al. Cardiac Home Education and Support Trial (CHEST): a pilot study. Canadian J Cardiol 2009;25:e393–e398
82. Harwood R.H. Foss A.J. Osborn F. et al. Falls and health status in elderly women following first eye cataract surgery: a randomised controlled trial. Br J Ophthalmol 2005;89:53–59.
83. Foss A.J. Harwood R.H. Osborn F. et al. Falls and health status in elderly women following second eye cataract surgery: a randomised controlled trial. Age Ageing 2006;35:66–71.
84. Menant J.C. Steele J.R. Menz H.B. et al. Optimizing footwear for older people at risk of falls. J Rehabil Res Dev 2008;45:1167–81.
85. Bergström U. Björnstig U. Stenlund H. et al. Fracture mechanisms and fracture pattern in men and women aged 50 years and older: a study of a 12-year population-based injury register, Umeå, Sweden. Osteoporos Int 2008;19:1267–73.
86. Gao C. Abeysekera J. A systems perspective of slip and fall accidents on icy and snowy surfaces. Ergonomics 2004;47:573–98.
87. McKiernan F.E. A simple gait-stabilizing device reduces outdoor falls and nonserious injurious falls in fall-prone older people during the winter. J Am Geriatr Soc 2005;53:943–7.
88. Spink M.J. Menz H.B. Fotoohabadi M.R. et al. Effectiveness of a multifaceted podiatry intervention to prevent falls in community dwelling older people with disabling foot pain: randomised controlled trial. BMJ 2011;342:d3411.
89. Cumming R.G. Thomas M. Szonyi G. et al. Home visits by an occupational therapist for assessment and modification of environmental hazards: a randomized trial of falls prevention. J Am Geriatr Soc 1999;47:1397–402.
90. Stevens M. Holman C.D. Bennett N. Preventing falls in older people: impact of an intervention to reduce environmental hazards in the home. J Am Geriatr Soc 2001;49:1442–7.
91. Cumming R.G. Ivers R. Clemson L. et al. Improving vision to prevent falls in frail older people: a randomized trial. J Am Geriatr Soc 2007;55:175–81.
92. Campbell A.J. Robertson M.C. La Grow S.J. et al. Randomised controlled trial of prevention of falls in people aged > or =75 with severe visual impairment: the VIP trial. BMJ 2005;331:817.
93. Ryan J.W. Spellbring A.M. Implementing strategies to decrease risk of falls in older women. J Gerontol Nurs 1996;22:25–31.
94. Pighills A.C. Torgerson D.J. Sheldon T.A. et al. Environmental assessment and modification to prevent falls in older people. J Am Geriatr Soc 2011;59:26–33.
95. Day L. Fildes B. Gordon I. et al. Randomised factorial trial of falls prevention among older people living in their own homes. BMJ 2002;325:128.
96. Nikolaus T. Bach M. Preventing falls in community-dwelling frail older people using a home intervention team (HIT): results from the randomized Falls-HIT trial. J Am Ger Soc 2003;51:300–5.
97. Clemson L. Mackenzie L. Ballinger C. et al. Environmental interventions to prevent falls in community-dwelling older people: a meta-analysis of randomized trials. J Aging Health 2008;20:954–71.
98. Nowak A. Hubbard R.E. Falls and frailty: lessons from complex systems. J R Soc Med 2009;102:98–102.
99. Hill S. Mossman J. Stockdale P. et al. A randomised controlled trial of a nurse-led falls prevention clinic. Age Ageing 2000;29(Suppl 2):20.
100. Clemson L. Cumming R.G. Kendig H. et al. The effectiveness of a community-based program for reducing the incidence of falls in the elderly: a randomized trial. J Am Geriatr Soc 2004;52:1487–94.
101. Shumway-Cook A. Silver I.F. Le Mier M. et al. Effectiveness of a community-based multifactorial intervention on falls and fall risk factors in community-living older adults: a randomized, controlled trial. J Gerontol A Biol Sci Med Sci 2007;62:1420–7.
102. Swanenburg J. de Bruin E.D. Stauffacher M. et al. Effects of exercise and nutrition on postural balance and risk of falling in elderly people with decreased bone mineral density: randomized controlled trial pilot study. Clin Rehabil 2007;21:523–34.
103. Assantachai P. Chatthanawaree W. Thamlikitkul V. et al. Strategy to prevent falls in the Thai elderly: a controlled study integrated health research program for the Thai elderly. J Med Assoc Thai 2002;85:215–22.
104. Hornbrook M.C. Stevens V.J. Wingfield D.J. et al. Preventing falls among community-dwelling older persons: results from a randomized trial. Gerontologist 1994;34:16–23.
105. Lord S.R. Tiedemann A. Chapman K. et al. The effect of an individualized fall prevention program on fall risk and falls in older people: a randomized, controlled trial. J Am Geriatr Soc 2005;53:1296–304.
106. Tinetti M.E. Baker D.I. McAvay G. et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med 1994;331:821–7.
107. Salminen M.J. Vahlberg T.J. Salonoja M.T. et al. Falls data (as supplied 20 May 2008) – unpublished data. Data on file 2008.
108. Wyman J. Gross C. Di Fabio R. et al. A randomized trial of exercise, education, and risk reduction counseling to prevent falls in populationbased sample of older women.] Gerontologist 2005;45(special issue II):297.
109. Carpenter G.I. Demopoulos G.R. Screening the elderly in the community: controlled trial of dependency surveillance using a questionnaire administered by volunteers. BMJ 1990;300:1253–6.
110. Gallagher E.M. Brunt H. Head over heels: impact of a health promotion program to reduce falls in the elderly. Can J Aging 1996;15(1):84–96.
111. Hogan D.B. MacDonald F.A. Betts J. et al. A randomized controlled trial of a community-based consultation service to prevent falls. CMAJ 2001;165:537–43.
112. Lightbody E. Watkins C. Leathley M. et al. Evaluation of a nurse-led falls prevention programme versus usual care: a randomized controlled trial. Age Ageing 2002;31:203–10.
113. Mahoney J.E. Shea T.A. Przybelski R. et al. Kenosha County falls prevention study: a randomized, controlled trial of an intermediate-intensity, community-based multifactorial falls intervention. J Am Geriatr Soc 2007;55:489–98.
114. Rubenstein L.Z. Alessi C.A. Josephson K.R. et al. A randomized trial of a screening, case finding, and referral system for older veterans in primary care. J Am Geriatr Soc 2007;55:166–74.
115. Elley C.R. Robertson M.C. Garrett S. et al. Effectiveness of a falls-and-fracture nurse coordinator to reduce falls: a randomized, controlled trial of at-risk older adults. J Am Geriatr Soc 2008;56:1383–9.
116. Gray-Donald K. Payette H. Boutier V. Randomized clinical trial of nutritional supplementation shows little effect on functional status among free-living frail elderly. J Nutr 1995;125:2965–71.
117. Reinsch S. MacRae P. Lachenbruch P.A. et al. Attempts to prevent falls and injury: a prospective community study. Gerontologist 1992;32:450–6.
118. Robson E. Edwards J. Gallagher E. et al. Steady as you go (SAYGO): A falls-prevention program for seniors living in the community. Can J Aging 2003; 22(2): 207–16.