prevention of falls
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Benefit/risk
- number needed to treat (NNT) strength & balance training
- 11 elderly persons for 1 year to prevent at least 1 fall
- no harm reported[1]
Management
- assessment of balance top priority
- no high-quality studies have been performed to determine if prehospital fall prevention screening can be effective in reducing in hospital falls[2]
- no reliable means of preventing falls in demented elderly
- individualized exercise program NOT effective
- antipsychotics NOT effective
- nursing home placement NOT effective[3]
- STOPPFALL is a tool for optimizing medication review for fall prevention[12]
- bundled fall interventions do not reduce falls in hospitalized elderly[4]
- in-hospital Fall Tailoring Interventions for Patient Safety (Fall TIPS) Program reduces falls by 19%, saving > $14,000 per 1,000 patient days[7]
- home hazard removal program did not reduce falls in high fall risk elderly living in low-income apartments[8]
- see falls in the elderly & prevention of fractures
Notes
- World Guidelines for Falls Prevention & Management's risk stratification algorithm in predicting falls with sensitivity score of 34% & specificity of 90% for predicting one or more falls with 24 months[13]
More general terms
Additional terms
References
- ↑ 1.0 1.1 The NNT: Strength and Balance Training Programs for Preventing Falls in the Elderly. http://www.thennt.com/nnt/strength-and-balance-programs-for-elderly-falls/
- ↑ 2.0 2.1 Zozula A et al. Prehospital emergency services screening and referral to reduce falls in community-dwelling older adults: A systematic review. Emerg Med J 2016 Jan 11 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26755748 <Internet> http://emj.bmj.com/content/early/2016/01/11/emermed-2015-204815.abstract
- ↑ 3.0 3.1 Medical Knowledge Self Assessment Program (MKSAP) 17, American College of Physicians, Philadelphia 2015
- ↑ 4.0 4.1 Barker AL, Morello RT, Wolfe R, et al. 6-PACK programme to decrease fall injuries in acute hospitals: cluster randomised controlled trial. BMJ. 2016;352:h6781 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26813674 Free PMC Article https://psnet.ahrq.gov/resources/resource/30134
- ↑ Vieira ER, Palmer RC, Chaves PH. Prevention of falls in older people living in the community. BMJ. 2016;353:i1419 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27125497
- ↑ Rothaus C. NEJM Resident 360. Feb 19, 2020 Prevention of Falls in the Elderly. https://resident360.nejm.org/clinical-pearls/prevention-of-falls-in-the-elderly
- ↑ 7.0 7.1 Dykes PC, Curtin-Bowen M, Lipsitz S et al. Cost of inpatient falls and cost-benefit analysis of implementation of an evidence-based fall prevention program. JAMA Health Forum. 2023;4(1):e225125. Feb 1. https://psnet.ahrq.gov/issue/cost-inpatient-falls-and-cost-benefit-analysis-implementation-evidence-based-fall-prevention
- ↑ 8.0 8.1 Krauss MJ, Somerville E, Bollinger RM, et al. Removing home hazards for older adults living in affordable housing: A stepped-wedge cluster-randomized trial. J Am Geriatr Soc. 2023 Dec 16 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38103187
- ↑ 9.0 9.1 El-Khoury F, Cassou B, Charles MA, Dargent-Molina P. The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: Systematic review and meta-analysis of randomised controlled trials. BMJ 2013 Oct 29; 347:f6234 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24169944 Free PMC Article <Internet> http://www.bmj.com/content/347/bmj.f6234
- ↑ Ganz DA, Latham NK Prevention of Falls in Community-Dwelling Older Adults. N Engl J Med. 2020 Feb 20;382(8):734-743. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32074420 Review. No abstract available
- ↑ Dautzenberg L, Beglinger S, Tsokani S et al Interventions for preventing falls and fall-related fractures in community-dwelling older adults: A systematic review and network meta-analysis. J Am Geriatr Soc. 2021 Oct;69(10):2973-2984. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34318929 PMCID: PMC8518387 Free PMC article.
- ↑ 12.0 12.1 Seppala LJ, Petrovic M, Ryg J et al STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk): a Delphi study by the EuGMS Task and Finish Group on Fall-Risk-Increasing Drugs. Age Ageing. 2021 Jun 28;50(4):1189-1199. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33349863 PMCID: PMC8244563 Free PMC article. https://academic.oup.com/ageing/article/50/4/1189/6043386
- ↑ 13.0 13.1 Ragusa FS, Di Bella G, Dominguez LJ, The role of the World Guidelines for Falls Prevention and Management's risk stratification algorithm in predicting falls: a retrospective analysis of the Osteoarthritis Initiative. Age Ageing. 2024 Aug 6;53(8):afae187. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39171386
- ↑ 14.0 14.1 Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022
- ↑ 15.0 15.1 Cadore EL et al Effects of different exercise interventions on risk of falls, gait ability and balance in physically frail older adults. A systematic review. Rejuvenation Res. 2013 Jan 17. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23327448
- ↑ Centers for Disease Control & Prevention (CDC). 2019 Algorithm for Fall Risk Screening, Assessment, and Intervention https://www.cdc.gov/steadi/pdf/STEADI-Algorithm-508.pdf