Table 3:
Interventions for preventing falls among older people living in the community (Gillespie et al.23)
| Intervention | Rate of falls* | Risk of falling* | ||||
|---|---|---|---|---|---|---|
|
|
|
|||||
| Rate ratio (95% CI) | No. of participants | No. of trials | Relative risk (95% CI) | No. of participants | No. of trials | |
| Exercise | ||||||
|
| ||||||
| Tai chi | 0.72 (0.52–1.00) | 1 563 | 5 | 0.71 (0.57–0.87) | 1 625 | 6 |
|
| ||||||
| Strength and resistance training | 1.80 (0.84–3.87) | 64 | 1 | 0.77 (0.52–1.14) | 120 | 1 |
|
| ||||||
| Walking groups | NR | NR | NR | 0.95 (0.77–1.18) | 222 | 1 |
|
| ||||||
| Any exercise interventions | NR | NR | NR | Risk of fall-related fracture: 0.34 (0.18–0.63) | 810 | 6 |
|
| ||||||
| Multicomponent group exercise (combination of 2 or more categories of exercise) | 0.71 (0.63–0.82) | 3 622 | 16 | 0.85 (0.76–0.96) | 5 333 | 22 |
|
| ||||||
| Multicomponent home-based exercise | 0.68 (0.58–0.80) | 951 | 7 | 0.78 (0.64–0.94) | 714 | 6 |
|
| ||||||
| Exercise training including only one of gait, balance or functional training | 0.72 (0.55–0.94) | 519 | 4 | 0.81 (0.62–1.97) | 453 | 3 |
|
| ||||||
| Vitamin D | ||||||
|
| ||||||
| Vitamin D supplementation | 1.00 (0.90–1.11) | 9 324 | 7 | 0.96 (0.89–1.03) | 26 747 | 13 |
|
| ||||||
| Vitamin D supplementation in people with low vitamin D levels | 0.57 (0.37–0.89) | 260 | 2 | 0.70 (0.56–0.87) | 804 | 4 |
|
| ||||||
| Home assessment | ||||||
|
| ||||||
| Home safety assessment and modification interventions | ||||||
|
| ||||||
| Overall | 0.81 (0.68–0.97) | 4 208 | 6 | 0.88 (0.80–0.96) | 4 051 | 7 |
|
| ||||||
| Led by occupational therapist | 0.69 (0.55–0.86) | 1 443 | 4 | 0.79 (0.70–0.91) | 1 153 | 5 |
|
| ||||||
| Not led by occupational therapist | 0.91 (0.75–1.11) | 3 075 | 4 | 0.94 (0.85–1.05) | 2 975 | 3 |
|
| ||||||
| Vision | ||||||
|
| ||||||
| Treatment of vision problems | 1.57 (1.19–2.06) | 616 | 1 | 1.54 (1.24–1.91) | 616 | 1 |
|
| ||||||
| Vision intervention: multifocal to single-lens glasses | Rates of falls and outside falls reduced in those who regularly took part in outside activities | 597 | 1 | Risk of all falls and outside falls increased in group with little participation in outside activities | 597 | 1 |
|
| ||||||
| First cataract surgery (women only) | 0.66 (0.45–0.95) | 306 | 1 | 0.95 (0.68–1.33) Risk of fall-related fracture: 0.33 (0.10–1.05) |
306 | 1 |
|
| ||||||
| Second cataract surgery | 0.68 (0.39–1.17) | 239 | 1 | 1.06 (0.69–1.63) | 239 | 1 |
|
| ||||||
| Other | ||||||
|
| ||||||
| Multifactorial interventions | 0.76 (0.67–0.86) | 9 503 | 19 | 0.93 (0.86–1.02) | 13 617 | 34 |
|
| ||||||
| Oral nutritional supplement | NR | NR | NR | 0.95 (0.83–1.08) | 1 902 | 3 |
|
| ||||||
| Gradual withdrawal of psychotropic medication | 0.34 (0.16–0.73) | 93 | 1 | 0.61 (0.32–1.17) | 93 | 1 |
|
| ||||||
| Medication review and modification | 1.01 (0.81–1.25) | 186 | 1 | 1.03(0.81–1.31) | 445 | 2 |
|
| ||||||
| Pacemakers (to treat carotid sinus hypersensitivity) | 0.73 (0.57–0.93) | 349 | 3 | 0.78 (0.18–3.39) | 171 | 1 |
|
| ||||||
| Antislip shoe device for icy conditions | 0.42 (0.22–0.78) | 109 | 1 | 0.56 (0.23–1.38) | 40 | 1 |
|
| ||||||
| Multifaceted podiatry (foot and ankle exercises) | 0.64 (0.45–0.91) | 305 | 1 | No reduction | 305 | 1 |
|
| ||||||
| Cognitive behavioural interventions | 1.00 (0.37–2.72) | 120 | 1 | 1.11 (0.80–1.54) | 350 | 2 |
|
| ||||||
| Education about fall prevention for patients | 0.33 (0.09–1.20) | 45 | 1 | 0.88 (0.75–1.03) | 2 555 | 4 |
|
| ||||||
| Professional development for family physicians,† with patient self-assessment, and medication review and modification | NR | NR | NR | 0.61 (0.41–0.91) | 659 | 1 |
Note: CI = confidence interval, NR = not reported.
*
Unless stated otherwise.
†
Included face-to-face education by a clinical pharmacist, feedback on prescribing practices and financial rewards.