Effectiveness of multifaceted fall-prevention programs for the elderly in residential care

Area of Science:

• Gerontology
• Public Health
• Geriatric Medicine

Background:

• Unintentional falls are a significant public health issue among the elderly, particularly in residential care settings.
• The effectiveness of comprehensive intervention programs for fall prevention in these facilities is not well-established.

Purpose of the Study:

• To evaluate the impact of multifaceted intervention programs on reducing falls, fallers, recurrent fallers, and injurious falls in older adults residing in care facilities.

Main Methods:

• Systematic review of randomized controlled trials identified through extensive database searches (Medline, PubMed, EMBASE) and internet engines up to July 2007.
• Inclusion criteria focused on elderly individuals in residential care participating in multifaceted fall-prevention programs.
• Data extraction and quality assessment were performed independently by two reviewers using the Downs and Black criteria, with narrative synthesis of results.

Main Results:

• Five well-conducted studies met the inclusion criteria.
• Significant reductions in recurrent fallers were reported in three studies, and in the number of falls in two studies.
• One study indicated a reduction in injurious falls, though its analysis was not intent-to-treat, leaving the finding inconclusive. No data on adverse events, costs, or sustainability were reported.

Conclusions:

• Multifaceted fall prevention programs demonstrate some efficacy in reducing falls and fallers in residential care settings.
• Further high-quality research is necessary to conclusively assess the impact on injurious falls, quality of life, cost-effectiveness, and long-term sustainability.