Table 5.

Continued.

WG/domains	Area or Domain	Recommendation	Grade
	Care Homes Management and Interventions	We recommend a multifaceted approach to falls reduction for care home residents including care home staff training, systematic use of a multidomain decision support tool and implementation of falls prevention actions	1B
	Care homes management and interventions	We recommend against the use of physical restraints as a measure for falls prevention in care homes.	1B
	Care homes management and interventions	We recommend nutritional optimisation including food rich in calcium and proteins, as well as vitamin D supplementation as part of a multidomain intervention for falls prevention in care home residents.	1B
	Care homes management and interventions	We recommend including the promotion of physical activity (when feasible and safe) as part of a multidomain falls prevention intervention in care homes.	1C
WG 6 Cognition and Falls	Cognition Assessment	We recommend that routine assessment of cognition should be included as part of multifactorial falls risk assessment in older adults.	1B
	Cognition Assessment	We recommend including both the older adult's and caregiver’s perspectives, when creating the individual falls prevention care plans for adults with cognitive impairment since this strategy has shown better adherence to interventions and outcomes.	1C
WG 7 Falls and PD and Related Disorders	Assessment	We conditionally recommend a falls risk assessment for older adults with PD, including a self-report 3-risk factor assessment tool, which includes a history of falls in the previous year, FOG in the past month, and slow gait speed	2B
	Management and Intervention	We conditionally recommend that older adults with PD be offered multidomain interventions	2B
	Management and 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 resistance training exercise.	1A
	Management and Intervention	We conditionally recommend exercise training, targeting balance and strength, be offered to people with complex phase PD if supervision by a physiotherapist or other suitably qualified professional is available.	1C
WG 8 Falls and Technology	Assessment and Interventions	We conditionally recommend using telehealth and/or smart home systems (when available) in combination with physical exercise as part of the falls prevention programmes in the community.	2C
	Interventions	Current evidence does not support the use of wearables for falls prevention. Emerging evidence show that when wearables are used in exercise programmes to prevent falls, they may increase participation.	2C
WG 9 Falls in Low- and Middle-Income Countries	Implementation	Local context needs to be considered when implementing fall prevention programmes in LMIC.	1B
	Assessment	We conditionally recommend prioritising assessments of risk factors for cognitive impairment, obesity including sarcopenic obesity, diabetes, lack of appropriate footwear and environmental hazards as falls risk factors in LMIC	2C
	Assessment	We conditionally recommend that in LMIC settings clinicians and caregivers use validated tools that are freely available in their country of residence to assess mobility, dependent on resource availability.	E
WG 10 Multifactorial Assessment and Interventions for Falls (Environment recommendations informed by the ad hoc expert group on Environment and Falls)	Multifactorial Assessment	We recommend multiprofessional, multifactorial assessment should be offered to community-dwelling older adults identified to be at high risk of falling, to guide tailored interventions.	1B
	Multidomain Interventions	We recommend multidomain interventions, informed by a multiprofessional, multifactorial falls risk assessment, should be offered to community-dwelling older adults identified to be at high risk of falling.	1B
	Multifactorial (Environmental) Assessment	We recommend identification of an individual’s environmental hazards where they live and an assessment of their capacities and behaviours in relation to them, by a clinician trained to do so, should be part of a multifactorial falls risk assessment.	1B
	Multifactorial (Environmental) Interventions	We recommend modifications of an older adult's physical home environment for fall hazards that consider their capacities and behaviours in this context, should be provided by a trained clinician, as part of a multidomain falls prevention intervention.	1B
WG 11 Older Adults' Perspectives on Falls	Stratification	We recommend clinicians should routinely ask about falls in their interactions with older adults.	1A
	Assessment	As part of a comprehensive fall assessment, clinicians should enquire about the perceptions the older adult holds about falls, their causes, future risk, and how they can be prevented.	1B
	Interventions	A care plan developed to prevent falls and related injuries should incorporate the goals, values and preferences of the older adult.	1B
WG 12 Concerns about Falling and Falls	Assessment	We recommend including an evaluation of concern about falling in a multifactorial falls risk assessment of older adults	1B
	Assessment	We recommend using a standardized instrument to evaluate concerns about falling such as the Falls Efficacy Scale International (FES-I) or Short FES-I in community-dwelling older adults.	1A
	Assessment	We recommend using the FES-I or especially the Short FES-I for assessing concerns about falling in acute care hospitals or long-term care facilities.	1B
	Assessment	We recommend exercise, cognitive behavioural therapy and/or occupational therapy (as part of a multidisciplinary approach) to reduce fear of falling in community-dwelling older adults.	1B

^*Note: these are the 12 original Working Groups that addressed the knowledge gaps identified from the review of previous clinical practice guidelines.