Table 5.

List of recommendations from the WFGs by Working Groups^*

WG/domains	Area or Domain	Recommendation	Grade
WG 1 Gait and Balance Assessment Tools to Assess Risk for Falls	Stratification	We recommend including gait speed for predicting falls risk. As an alternative the Timed Up and Go Test can be considered, although the evidence for fall prediction is less consistent.	1A 1B
	Assessment	We recommend that Gait and Balance should be assessed.	1B
WG 2 Polypharmacy, Fall Risk Increasing Drugs, and Falls	Assessment	We recommend assessing for fall history and the risk of falls before prescribing potential fall risk increasing drugs (FRIDs) to older adults.	1B
	Assessment	We recommend the use of a validated, structured screening and assessment tool to identify FRIDs when performing a medication review or medication review targeted to falls prevention in older adults.	1C
	Intervention	We recommend that medication review and appropriate deprescribing of FRIDs should be part of multidomain falls prevention interventions.	1B
	Intervention	We recommend that in long-term care residents, the falls prevention strategy should always include rational deprescribing of fall-risk-increasing drugs.	1C
WG 3 Cardiovascular Risk Factors for Falls	Assessment	We recommend, as part of a multifactorial falls risk assessment, that a cardiovascular assessment that initially include cardiac history, auscultation, lying and standing orthostatic blood pressure, and surface electrocardiogram should be performed.	1B
	Assessment	In the absence of abnormalities on initial cardiovascular assessment, no further cardiovascular assessment is required, unless syncope is suspected (i.e. recurrent unexplained falls).	1C
	Assessment	We recommend that the further cardiovascular assessment for unexplained falls should be the same as that for syncope, in addition to the multifactorial falls risk assessment.	1A
	Intervention	We recommend that management of orthostatic hypotension should be included as a component of multidomain intervention in fallers.	1A
	Intervention	We recommend that interventions for cardiovascular disorders identified during assessment for risk of falls should be the same as that for similar conditions when associated with syncope, in the addition to other interventions based on the multifactorial falls risk assessment.	1B
WG 4 Exercise Interventions for Prevention of Falls and Related Injuries	Exercise Intervention	We recommend exercise programmes for fall prevention for community-dwelling older adults which include balance challenging and functional exercises (e.g. sit-to-stand, stepping), with sessions three times or more weekly which are individualised, progressed in intensity for at least 12 weeks and continued longer for greater effect.	1A
	Exercise Intervention	We recommend inclusion, when feasible, of Tai Chi and/or additional individualised progressive resistance strength training.	1B
	Exercise Intervention	We recommend individualised supervised exercise as a falls prevention strategy for adults living in long-term care settings.	1B
	Exercise Intervention	We recommend that adults with PD at an early to mid-stage and with mild or no cognitive impairment are offered individualised exercise programmes including balance and resistant training exercise	1A
	Exercise Intervention	We conditionally recommend that adults after a stroke participate in individualised exercise aimed at improving balance/strength/walking to prevent falls	2C
	Exercise Intervention	We recommend that adults after sustaining a hip fracture participate in individualised and progressive exercise aimed at improving mobility (i.e. standing up, balance, walking, climbing stairs) as a fall prevention strategy.	1B
	Exercise Intervention	We conditionally recommend that such programmes after a hip fracture be commenced as in-patients and be continued in the community.	2C (In-patients) & 1A (Community)
	Intervention	We recommend that community-dwelling adults with cognitive impairment (mild cognitive impairment and mild to moderate dementia) participate in exercise to prevent falls, if willing and able to do so.	1B
WG 5 Falls in Hospitals and Care Homes	Hospital Assessment	We recommend that hospitalised older adults >65 years of age have a multifactorial falls risk assessment. We recommend against using scored falls risk screening tools in hospitals for multifactorial falls risk assessment in older adults.	2B
	Hospitals management and interventions	We recommend that tailored education on falls prevention should be delivered to all hospitalised older adults (≥65 years of age) and other high-risk groups.	1A
	Hospitals management and interventions	We recommend that personalised single or multidomain falls prevention strategies based on identified risk factors or behaviours (or situations) be implemented for all hospitalised older adults (≥65 years of age), or younger individuals identified by the health professionals as at risk of falls.	1C (Acute care) & 1B (Sub-acute care)
	Care homes assessment	We recommend against falls risk screening to identify care home residents at risk for falls and we recommend that all residents should be considered at high risk of falls.	1A
	Care homes assessment	We recommend performing a multifactorial falls risk assessment at admission to identify factors contributing to fall risk and implementing appropriate interventions to avoid falls and fall-related injuries in care home resident older adults.	1C
	Care homes assessment	We recommend conducting a post-fall assessment in care home residents following a fall in order to reassess fall risk factors, adjust the intervention strategy for the resident and avoid unnecessary transfer to acute care.	E

(Continued)