Effectiveness of a home hazard modification program for reducing falls in urban community‐dwelling older adults: A randomized controlled trial

Kamei, Tomoko; Kajii, Fumiko; Yamamoto, Yuko; Irie, Yukako; Kozakai, Rumi; Sugimoto, Tomoko; Chigira, Ayako; Niino, Naoakira

doi:10.1111/jjns.12059

Cited by 52 publications

(68 citation statements)

References 25 publications

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“…An additional 11 RCTs were identified that were conducted in Asian populations, met the inclusion criteria for the community based falls prevention Cochrane review, and were published after the 2012 Cochrane review (Japan n = 6; [ 43 – 48 ] Taiwan n = 2; [ 49 , 50 ] and China/Hong Kong, [ 51 ] Malaysia [ 52 ] and Singapore [ 53 ] n = 1 each). See Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Combining the Asian studies in the 2012 Cochrane review and subsequent Asian RCTS, the only single intervention types that had more than one randomized controlled trial conducted in Asia were exercise ( n = 15), and environment (home hazard assessment and modification, n = 2 [ 38 , 48 ]). There were also five multiple intervention studies [ 34 , 37 , 41 , 50 , 53 ] (two with two or more single intervention arms included as separate single interventions in the single intervention analyses [ 34 , 37 ]) and four multifactorial intervention studies conducted in Asia [ 35 , 36 , 39 , 40 ].…”

Section: Resultsmentioning

confidence: 99%

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What works in falls prevention in Asia: a systematic review and meta-analysis of randomized controlled trials

et al. 2018

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BackgroundThere is strong research evidence for falls prevention among older people in the community setting, although most is from Western countries. Differences between countries (eg sunlight exposure, diet, environment, exercise preferences) may influence the success of implementing falls prevention approaches in Asian countries that have been shown to be effective elsewhere in the world. The aim of this review is to evaluate the scope and effectiveness of falls prevention randomized controlled trials (RCTs) from the Asian region.MethodRCTs investigating falls prevention interventions conducted in Asian countries from (i) the most recent (2012) Cochrane community setting falls prevention review, and (ii) subsequent published RCTs meeting the same criteria were identified, classified and grouped according to the ProFANE intervention classification. Characteristics of included trials were extracted from both the Cochrane review and original publications. Where ≥2 studies investigated an intervention type in the Asian region, a meta-analysis was performed.ResultsFifteen of 159 RCTs in the Cochrane review were conducted in the Asian region (9%), and a further 11 recent RCTs conducted in Asia were identified (total 26 Asian studies: median 160 participants, mean age:75.1, female:71.9%). Exercise (15 RCTs) and home assessment/modification (n = 2) were the only single interventions with ≥2 RCTs. Intervention types with ≥1 effective RCT in reducing fall outcomes were exercise (6 effective), home modification (1 effective), and medication (vitamin D) (1 effective). One multiple and one multifactorial intervention also had positive falls outcomes. Meta-analysis of exercise interventions identified significant benefit (number of fallers: Odds Ratio 0.43 [0.34,0.53]; number of falls: 0.35 [0.21,0.57]; and number of fallers injured: 0.50 [0.35,0.71]); but multifactorial interventions did not reach significance (number of fallers OR = 0.57 [0.23,1.44]).ConclusionThere is a small but growing research base of falls prevention RCTs from Asian countries, with exercise approaches being most researched and effective. For other interventions shown to be effective elsewhere, consideration of local issues is required to ensure that research and programs implemented in these countries are effective, and relevant to the local context, people, and health system. There is also a need for further high quality, appropriately powered falls prevention trials in Asian countries.Electronic supplementary materialThe online version of this article (10.1186/s12877-017-0683-1) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

What works in falls prevention in Asia: a systematic review and meta-analysis of randomized controlled trials

et al. 2018

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“…The different examples of lighting interventions that have been studied in the past are: (i) unilateral light paths similar to Gight [21,26,27], (ii) LED strips positioned on and around objects and doors to provide spatial lighting cues [24,32], and (iii) bilateral pathway demarcation with laser lines [33]. Additionally, more awareness should be raised to the importance of appropriate lighting during nightly ambulation, as older people are often unaware of insufficient lighting [34].…”

Section: Further Course Of Action and Areas Of Further Researchmentioning

confidence: 99%

A Guiding Nightlight Decreases Fear of Falling and Increases Sleep Quality of Community-Dwelling Older People: A Quantitative and Qualitative Evaluation

Thölking

Lamers²,

Rikkert

2020

Gerontology

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Background: Even though poor lighting at nighttime is an important risk factor for falls (and most falls occur during the night), lighting interventions to improve nightly lighting from bed to bathroom are rarely evaluated for fall prevention. Objective: We tested the hypothesis that an automated guiding light would reduce nightly fear of falling (FOF) and increase sleep quality of community-dwelling older people. Methods: This study had a pragmatic uncontrolled beforeafter design, including participants during a period of 8 months if they (i) were aged at least 65 years, (ii) ambulated independently at night, and (iii) had no cognitive or audiovisual impairments obstructing outcome measurement. Automated LED strips (Gight TM ) were installed in the participants' homes. The primary outcome measure was overnight FOF on a scale of 0-10. Secondary outcome measures included sleep quality on a scale of 0-10 and fall rate. Additionally, a sample of participants was interviewed about their experiences with Gight. Results: Sixty-four participants were included (mean age: 80.8 ± 8.1 years; 89% living independently). Mean study length was 118 days (range: 30-231). In the intention-to-treat analysis, overnight FOF declined from 5.5 ± 3.0 to 3.8 ± 3.2 (p = 0.001), and sleep quality increased from 6.7 ± 2.4 to 7.4 ± 1.7 (p = 0.012). The fall rate during the study was too low to detect changes. Participants appreciated Gight (8.4 ± 0.8 on a scale of 10), and the majority (57%) reported a subjective decrease in FOF. Conclusion: Gight shows promising results for overnight FOF and sleep quality, but the effect of lighting interventions on fall rate should be evaluated further before widespread implementation.

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“…19 There was a 12% reduction in falls occurring in the home at 52 weeks. 19 Thus, improved awareness of fall prevention and knowledge regarding home safety requirements are potential factors in reducing the risk of falls.…”

Section: Discussionmentioning

confidence: 95%

“…In a Japanese randomized controlled trial testing an intervention to improve fall prevention for approximately four times (2 h per program), which included educational sessions regarding risk factors for falls, such as food and nutrition, foot self‐care, exercise and home safety practices, using a model mock‐up of a typical Japanese home, was shown to be effective . There was a 12% reduction in falls occurring in the home at 52 weeks . Thus, improved awareness of fall prevention and knowledge regarding home safety requirements are potential factors in reducing the risk of falls.…”

Section: Discussionmentioning

confidence: 99%

Environmental and physical factors predisposing middle‐aged and older Japanese adults to falls and fall‐related fractures in the home

Tanaka

Matsumoto

Son

et al. 2018

Geriatrics Gerontology Int

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Effectiveness of a home hazard modification program for reducing falls in urban community‐dwelling older adults: A randomized controlled trial

Cited by 52 publications

References 25 publications

What works in falls prevention in Asia: a systematic review and meta-analysis of randomized controlled trials

What works in falls prevention in Asia: a systematic review and meta-analysis of randomized controlled trials

A Guiding Nightlight Decreases Fear of Falling and Increases Sleep Quality of Community-Dwelling Older People: A Quantitative and Qualitative Evaluation

Environmental and physical factors predisposing middle‐aged and older Japanese adults to falls and fall‐related fractures in the home

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