Conclusion: Strong indications for effectiveness
Multifactorial intervention programmes can reduce the number of falls in community-dwelling elderly people by around 25%. The evidence in nursing homes is not so clear although a multidisciplinary, multifactorial approach has been successful. A multifactorial programme consists of different combinations of interventions based on an individual assessment of the elderly person.
Recommendations (for research & practice)
After a fall or fall injury older people should be offered a multidisciplinary assessment and interventions to address the fall risks identified. Active treatments are considerd preferrable to referral alone.
For community programmes, single factor, targeted inteventions are recommended (for example exercise programmes) because they are equally as effective as multifactorial interventions in reducing falls and may be more acceptable and cost-effective.
Referral is considered to be insufficient as a soletary measure; effective interventions are recognised as active measures matching with the target population.
Review Date: 17/11/2009
Version: 1.0
Status: Publish
Procedure
First the titles and then abstracts were scanned in order to include relevant studies. In the case of insufficient information obtained from abstracts the full text articles were obtained. Recent reviews and meta-analyses, were selected and scrutinised. The selection was completed with articles of a later date and background documents were created. The resulting evidence statements were subjected to expert review and if necessary adapted.
Background documents
Interventions for preventing falls in older people living in the community (version 1)
L.D. Gillespie, M.C. Robertson, W.J. Gillespie ... [et al.] (2009)
Rethinking individual and community fall prevention strategies : a meta-regression comparing single and multifactorial interventions (version 1)
A.John Campbell, M.Clare Robertson (2007)
The effectiveness of a community-based program for reducing the incidence of falls in the elderly: a randomized trial (version 1)
Lindy Clemson, Robert G. Cumming, Hal Kendig ... [et al.] (2004)
Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment : systematic review and meta-analyses (version 1)
David Oliver, James B. Connelly, Christina R. Victor...[et al] (2007)
Effectiveness of multifaceted fall-prevention programs for the elderly in residential care (version 1)
M.D. Cusimano, J, Kwok, K. Spadafora (2008)