Interventions for preventing falls in older people living in the community

Gillespie, Lesley D; Robertson, M. Clare; Gillespie, W. J.; Lamb, Sarah E; Gates, Simon; Cumming, Robert; Rowe, Brian H.

doi:10.1002/14651858.cd007146

Cited by 287 publications

(437 citation statements)

References 17 publications

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“…There is compelling evidence that falls in community dwelling seniors are preventable [10]. Therefore, there is potential to reduce health care costs and improve quality of life by preventing falls [6].…”

Section: Introductionmentioning

confidence: 99%

Guidelines for conducting and reporting economic evaluation of fall prevention strategies

et al. 2010

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Section: Introductionmentioning

confidence: 99%

Guidelines for conducting and reporting economic evaluation of fall prevention strategies

et al. 2010

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“…Thus, the balance and tone comparator is relevant at an international context where such programs are offered to older adults in the community. Further, this economic evaluation may provide an overly conservative estimate of the health benefit of the once-and twice-weekly resistance training classes given the already demonstrated benefits of tai chi for falls prevention [8].…”

Section: Rationale For Balance and Tone Comparatormentioning

confidence: 99%

“…It is, however, consistent with programs available in the 'real world'; the balance and tone comparator is relevant in communities where balance and tone classes such as Osteofit, not specifically aimed at fall prevention, are provided. Previous research demonstrated that exercises including balance [37], resistance training [9], or balance and resistance training [8,15] in combination may reduce falls. Consequently, our evaluation may provide an overly conservative estimate of the health benefit of the resistance training classes given that the participants may also have experienced a positive health benefit from the balance and tone classes (comparator).…”

Section: Time Horizonmentioning

confidence: 99%

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Economic evaluation of dose–response resistance training in older women: a cost-effectiveness and cost-utility analysis

et al. 2010

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“…8 While the revised guidelines now recognize the importance of these two factors, the information from fall-prevention studies is less instructive on how best to directly address fear of falling and low selfefficacy. 7,9 The important contribution of the study by Arnold and colleagues 1 is the use of a direct treatment approach to improve falls self-efficacy using an educational intervention in conjunction with exercises to reduce fall risk.…”

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confidence: 99%

Clinician's Commentary on Arnold et al.

Muir

2011

Physiotherapy Canada

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Adults over age 65 are the fastest-growing segment of the Canadian population. In this age group, the magnitude and scope of the morbidity and mortality sequelae of a fall are sobering, clearly highlighting the pivotal public-health importance of the problem of falls in older adults, which can initiate a progressive decline in function, loss of independence, and a decrease in quality of life.Older adults experience not only physical trauma but also psychological consequences related to falls. 2 The psychological issues associated with falling, or with the prospect of falling, can be as disabling as the fall itself, if not more so. 3,4 These psychological consequences can be conceptualized across the dimensions of fear, self-efficacy, activity avoidance, and loss of confidence. 2 Dealing with the psychological consequences of falls is crucial, as the prevalence of fear of falling ranges from 12% to 65% among older adults who have not fallen and from 29% to 92% among those who have. 2,5 Fear of falling may reflect an individual's realistic appraisal of reduced functional abilities that place him or her at an increased fall risk, as demonstrated by the moderate to strong associations that have been found between the Activities-specific Balance Confidence (ABC) Scale and measures of balance, gait, self-reported physical function, and activity restriction. 6 On the other hand, a fear of falling may also reflect a negative affective state that limits the performance of activities that the person is functionally capable of performing. 5 Unfortunately, a fear of falling can initiate a debilitating spiral of restricted activities, loss of functional ability, loss of confidence, physical frailty, and loss of independence. 7 The recent updated fall-prevention guidelines from the American Geriatrics Society include, for the first time, the specific recommendation to assess an individual's perceived functional ability and fear related to falling. 8 While the revised guidelines now recognize the importance of these two factors, the information from fall-prevention studies is less instructive on how best to directly address fear of falling and low selfefficacy. 7,9 The important contribution of the study by Arnold and colleagues 1 is the use of a direct treatment approach to improve falls self-efficacy using an educational intervention in conjunction with exercises to reduce fall risk.Key challenges in fall prevention include successfully identifying people at risk, understanding the interaction of risk factors, and targeting meaningful treatment to improve or maintain functional autonomy and quality of life. The goal of rehabilitation is for our clients to develop the function and skills that allow post-training performance in real-world situations; rehabilitation therefore includes addressing physical and affective dimensions of ability, to enhance carry-over and function after training. There is a distinction to be made between fear of falling and falls efficacy, defined as the perceived ability to confidently undertake act...

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Interventions for preventing falls in older people living in the community

Cited by 287 publications

References 17 publications

Guidelines for conducting and reporting economic evaluation of fall prevention strategies

Guidelines for conducting and reporting economic evaluation of fall prevention strategies

Economic evaluation of dose–response resistance training in older women: a cost-effectiveness and cost-utility analysis

Clinician's Commentary on Arnold et al.

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