Options to prevent falls in the elderly

The Cochrane Library has reviewed the data and found 3 effective strategies that reduce the rate and risk of falling.

First, the details.

• 111 studies in 55,303 participants were included in the review.
• The reviewers distinguished between rate of falls vs. risk of falling.

And, the results.
Reduced rate of falls and risk of falling

• Individually prescribed multiple-component home-based exercise
• Multiple-component group exercise
• Tai chi
  • Reductions in fall risk ranged from 17% for multicomponent group exercise to 35% for tai chi.

Reduced rate of falls only

• Multifactorial intervention
• Gradual withdrawal of psychotropic drugs
• Pacemakers in people with carotid sinus hypersensitivity
• First eye cataract surgery

Reduced risk of falling

• Prescribing modification program for primary care physicians

Other strategies

• Vitamin D did not reduce falls.
  • Might be effective in people with low vitamin D levels.
• Home safety interventions did not reduce falls overall.
  • Effective in people with severe visual impairment.
  • Effective in people at higher risk of falling.
• An anti-slip shoe device reduced rate of falls in icy conditions.

The bottom line?
There are lots of effective options. And there’s even some evidence that fall prevention strategies can be cost saving.

A good review of the details of this report can be found at Medpage Today. For example…

• Extra care is needed for patients with severe vision or mobility problems.
• Regimens addressing at least 2 physical attributes (strength, endurance, flexibility, and balance) are most effective.
• No exercise that targeted just one attribute significantly reduced the risk of falling, although fall rates were reduced.

What’s needed is a champion to encourage their use.

To help get started, the CDC offers a book covering “specific interventions that have rigorous scientific evidence of effectiveness” in lowering the risk of falls among the elderly. The European Commission also has guidelines for exercise programs for the frail elderly.

More on the effects of a simplified tai chi program for the elderly in long-term care is here.

4/16/09 10:42 JR