Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials

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dc.contributorVirginia Techen
dc.contributor.authorChang, John T.en
dc.contributor.authorMorton, Sally C.en
dc.contributor.authorRubenstein, Laurence Z.en
dc.contributor.authorMojica, Walter A.en
dc.contributor.authorMaglione, Margareten
dc.contributor.authorSuttorp, Marika J.en
dc.contributor.authorRoth, Elizabeth A.en
dc.contributor.authorShekelle, Paul G.en
dc.date.accessioned2017-10-19T15:36:56Zen
dc.date.available2017-10-19T15:36:56Zen
dc.date.issued2004-03-20en
dc.description.abstractObjective: To assess the relative effectiveness of interventions to prevent falls in older adults to either a usual care group or control group. Design: Systematic review and meta-analyses. Data sources Medline, HealthSTAR, Embase, the Cochrane Library, other health related databases, and the reference lists from review articles and systematic reviews. Data extraction: Components of falls intervention: multifactorial falls risk assessment with management programme, exercise, environmental modifications, or education. Results: 40 trials were identified. A random effects analysis combining trials with risk ratio data showed a reduction in the risk of falling (risk ratio 0.88, 95% confidence interval 0.82 to 0.95), whereas combining trials with incidence rate data showed a reduction in the monthly rate of falling (incidence rate ratio 0.80, 0.72 to 0.88). The effect of individual components was assessed by meta-regression. A multifactorial falls risk assessment and management programme was the most effective component on risk of falling (0.82, 0.72 to 0.94, number needed to treat 11) and monthly fall rate (0.63, 0.49 to 0.83; 11.8 fewer falls in treatment group per 100 patients per month). Exercise interventions also had a beneficial effect on the risk of falling (0.86, 0.75 to 0.99, number needed to treat 16) and monthly fall rate (0.86, 0.73 to 1.01; 2.7). Conclusions: Interventions to prevent falls in older adults are effective in reducing both the risk of falling and the monthly rate of falling. The most effective intervention was a multifactorial falls risk assessment and management programme. Exercise programmes were also effective in reducing the risk of falling.en
dc.description.sponsorshipThis work was supported by a contract (No 500-98-0281) from the Centers for Medicare and Medicaid Services, United States Department of Health and Human Services to RAND Health. JTC was supported by a National Research Service Award training grant (PE-19001) and the UCLA Specialty Training and Advanced Research programme. PGS was a senior research associate of the Veterans Affairs Health Services Research and Development Service.en
dc.identifier.doihttps://doi.org/10.1136/bmj.328.7441.680en
dc.identifier.issue7441en
dc.identifier.urihttp://hdl.handle.net/10919/79709en
dc.identifier.volume328en
dc.language.isoen_USen
dc.publisherBMJ Publishing Group Ltden
dc.rightsIn Copyrighten
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en
dc.titleInterventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trialsen
dc.title.serialBMJen
dc.typeArticle - Refereeden

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