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Abstract
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Falls in older people are common, with 1 in 3 people over 65 years of age and half of those over 80 years of age likely to have at least one fall each year.[1] Whilst many falls result in minor injuries, 10% to 20% of falls in this age group result in fractures,[2] and each year an estimated 684,000 older people globally have falls that result in death.[3] In 2017, almost 172 million falls led to new injuries.[4] Loss of confidence after falls may also reduce an older person's physical activity and lead to social isolation.[5] Falls are a common reason for admission to care facilities,[6] and a significant economic burden on inpatient care.[7]
The first Cochrane Review on fall prevention strategies in older people was published in 1997. Since then, the review has had regular updates and has been split into separate reviews ‐ first into different population groups (people living in the community and people living in care settings), and then according to more specific types of interventions. This has been driven by ongoing research in this field, demonstrating the increasing importance given to preventable injuries in older people.
The Cochrane Review and meta‐analysis by Clemson and colleagues evaluated one of these more specific intervention types ‐ environmental approaches to reducing the risk of falls in older people living in the community.[8] These interventions are aimed at improving safety at home, outdoors, and in community and public places. The review authors grouped the interventions into four categories based on the Prevention of Falls Network Europe (ProFaNE) taxonomy:[9] home fall‐hazard reduction interventions; assistive technology interventions; education interventions; and home modifications.
The review included 22 studies involving 8463 community‐residing older people. Most of the available evidence (14 studies, 5830 participants) was for just one of the pre‐specified intervention categories: home fall‐hazard reduction interventions. In these studies, participants were typically visited by an occupational therapist in their own home. Usually, this was a single visit with follow‐up such as a telephone call. Some studies, however, conducted a second or further visits if required. The purpose of the visits was to identify and assess fall hazards, raise awareness of fall risks, jointly problem‐solve, and in some cases also provide assistive technologies. Studies included populations with variable baseline risks of falling; although there was a subset of studies conducted only in older people at higher risk of falling...
Language: en |