News Release

Preventing falls in elderly people

Peer-Reviewed Publication

BMJ

Effects of a programme of multifactorial home visits on falls and mobility impairments in elderly people at risk: randomised controlled trial

Guidelines for the prevention of falls in people over 65

Falling is a serious problem among elderly people, with a substantial impact on health and healthcare costs. Two papers in this week's BMJ explore the effectiveness of various strategies to prevent falls and reduce mobility problems among elderly people, improving our ability to address this serious public health problem.

Haastregt and colleagues identified over 300 people aged 70 and over and living in the community, with mobility problems or a history of recent falls. Over a period of one year, half received five home visits by a community nurse. The other half did not receive any special intervention. They found that home visits had no effect on falls and mobility problems. Furthermore, the home visits had no effects on other factors such as physical complaints, perceived health, social functioning and loneliness.

A programme of home visits is clearly not effective at reducing falls and mobility problems in elderly people at risk living in the community, say the authors. Alternative strategies need to be developed and tested in different healthcare settings, they conclude.

Feder and colleagues translated evidence, based on 21 trials about prevention of falls, into recommendations that can be implemented in different healthcare settings. To test their feasibility in different care settings, the guidelines were piloted in two general practices, a residential home and a general hospital. Despite large gaps in the evidence, the authors recommend focusing on multifaceted programmes of intervention, assessment of high risk residents in nursing homes and the provision of hip protectors for residents of nursing homes to reduce falls. Home assessment of older people at risk of falls is not recommended.

The authors stress the need for further research in many areas, and suggest that these guidelines should be regularly updated as new evidence emerges.

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Contacts:

Jolanda C M van Haastregt, Health Scientist, Institute for Rehabilitation Research, Netherlands
Email: jolanda.vanhaastregt@irv.nl

Professor Gene Feder, Queen Mary and Westfield College, London, UK
Email: g.s.feder@mds.qmw.ac.uk


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