Evidence for interventions
NICE guidelines for assessing falls risk and falls prevention in older people highlight the following as key strategies:
- Case/risk identification: Older people in contact with healthcare professionals should be asked routinely whether they have fallen in the past year.
- Multifactorial falls risk assessment: Should be offered to all older people who present for medical attention because of a fall or report recurrent falls in the past year.
- Multifactorial interventions: Should be offered to all older people identified as being at increased risk of falling. This should include strength and balance training, home hazard assessment and intervention, visual assessment, medication review with modification/withdrawal.
Conclusions from a Cochrane systematic review reported that; there is strong evidence that certain exercise programmes and home safety interventions are effective in both reducing the risk of and rate of falls amongst older people.
- Group exercise classes reduced the rate of falls by 29% and the risk of falling by 15%.
- Home-based exercise reduced the rate of falls by 32% and the risk of falls by 22%.
- Home safety interventions reduce rate of falls by 19% and risk of falling by 12%.
More recent systematic reviews have confirmed the Cochrane findings that exercise programmes are the most effective intervention for preventing falls in older adults, especially strength and balance exercise programmes.