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Multi-component fall prevention interventions for older adults

Health Factors: Quality of Care Community Safety
Decision Makers: State Government Healthcare Professionals & Advocates Public Health Professionals & Advocates
Evidence Rating: Scientifically Supported
Population Reach: 10-19% of WI's population
Impact on Disparities: No impact on disparities likely

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Description

A fixed, multi-component set of fall prevention interventions are often provided to older adults in community settings and may also be implemented in long-term care or clinical settings (Goodwin 2014). Such interventions typically include some combination of exercise, education, home or environmental modification, medication optimization, and vitamin D supplementation and can be provided without undertaking individual risk assessments (Cochrane-Cameron 2012, Goodwin 2014). Falls can lead to long-term physical injuries, increased risk of early death, and psychological concerns such as fear of falling and loss of confidence (CDC-Falls, Cochrane-Gillespie 2012).

Expected Beneficial Outcomes

Reduced falls

Evidence of Effectiveness

There is strong evidence that multi-component fall prevention interventions reduce the rate of falls and the risk of falling among older adults (Goodwin 2014, Cochrane-Gillespie 2012). Additional evidence is needed to determine the most effective combinations of intervention components.

Multi-component interventions are effective in community and clinical settings. Such efforts can reduce the rate and risk of falls for older adults who live independently in the community, and may also benefit those living in care facilities. Including an exercise component in the multi-component intervention may increase reductions in fall rates (Goodwin 2014). 

Implementation

United States

The National Council on Aging (NCOA) leads the National Falls Prevention Resource Center, which supports implementation of fall prevention programs across the country and coordinates the Falls Free® Initiative, which includes 43 state-level coalitions (NCOA-Falls prevention). This initiative promotes several approaches to fall prevention, including multi-component programs for older adults in communities and clinics.

Wisconsin

In 1991, the Wisconsin Falls Prevention Initiative (FPI) was developed to reduce falls and fall-related complications across the state. In 2015, the coalition included health care providers, educators, researchers, organizations serving older adults, social service professionals, and state government officials. FPI promotes implementation of tested fall prevention interventions, including Stepping On, a multi-component, community-based workshop to help older adults develop specific knowledge and skills to prevent falls (WI DHS-Falls).

Implementation Resources

CDC-STEADI - Centers for Disease Control and Prevention (CDC). STEADI (Stopping Elderly Accidents, Deaths & Injuries) tools for health care providers and patients. Accessed on February 2, 2016
IHI-TCAB* - Institute for Healthcare Improvement (IHI). Transforming Care at the Bedside how-to guide: Reducing patient injuries from falls. Accessed on January 26, 2016
NCOA-Falls prevention - National Council on Aging (NCOA). National falls prevention resource center. Accessed on January 26, 2016

Citations - Description

CDC-Falls - Centers for Disease Control and Prevention (CDC). Falls - older adults. Accessed on January 26, 2016
Cochrane-Cameron 2012* - Cameron ID, Gillespie LD, Robertson MC, et al. Interventions for preventing falls in older people in care facilities and hospitals: Review. The Cochrane Database of Systematic Reviews. 2012;(12):CD005465. Accessed on January 26, 2016
Cochrane-Gillespie 2012* - Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community: Review. The Cochrane Database of Systematic Reviews. 2012;(9):CD007146. Accessed on January 26, 2016
Goodwin 2014 - Goodwin VA, Abbott RA, Whear R, et al. Multiple component interventions for preventing falls and fall-related injuries among older people: Systematic review and meta-analysis. BMC Geriatrics. 2014;14:15. Accessed on January 26, 2016

Citations - Evidence

Cochrane-Gillespie 2012* - Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for preventing falls in older people living in the community: Review. The Cochrane Database of Systematic Reviews. 2012;(9):CD007146. Accessed on January 26, 2016
Goodwin 2014 - Goodwin VA, Abbott RA, Whear R, et al. Multiple component interventions for preventing falls and fall-related injuries among older people: Systematic review and meta-analysis. BMC Geriatrics. 2014;14:15. Accessed on January 26, 2016

Citations - Implementation

NCOA-Falls prevention - National Council on Aging (NCOA). National falls prevention resource center. Accessed on January 26, 2016
WI DHS-Falls - Wisconsin Department of Health Services (WI DHS). Falls prevention--older adults. Accessed on January 26, 2016

Page Last Updated

February 1, 2016

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