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Guidelines for the prevention of falls in people over 65

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TLDR
These guidelines translate trial evidence about prevention of falls into recommendations that can be implemented in different settings, with the aim of reducing the rate of falls and injurious falls in people over 65.
Abstract
General practice p 994 Older people frequently fall. This is a serious public health problem, with a substantial impact on health and healthcare costs.1 These guidelines translate trial evidence about prevention of falls into recommendations that can be implemented in different settings, with the aim of reducing the rate of falls and injurious falls in people over 65 (see boxes 2 3). #### Summary points Multifaceted interventions reduce falls in older people (those over 65) Home assessment of older people at risk of falls without referral or direct intervention is not recommended Assessment of high risk residents in nursing homes with relevant referral is effective Evidence from well designed single trials shows that assessment and modification of risk factors of older people who have presented to an accident and emergency department after a fall and the provision of hip protectors in residents of nursing homes are effective We updated two previous systematic reviews to include any new evidence up to March 1998. 4 5 We electronically searched Medline for all randomised controlled trials and systematic reviews by using the terms fall(s), accidental falls, fracture, elderly, aged, older, and senior. We followed up relevant references in papers, and we contacted researchers in prevention of falls for information about other trial evidence and about studies from journals not catalogued by the National Library of Medicine. For inclusion, studies had to be randomised controlled trials of interventions designed to minimise or prevent exposure to the risk factors for falling (or fracture) in people aged 65 years or over living in either community or residential care. Outcomes had to include the number of people who had fallen or the number of falls or fractures. We excluded drug or dietary treatments for the prevention of fractures. Trials that fulfilled the inclusion criteria were reviewed and summarised …

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Citations
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Journal ArticleDOI

Incidence and mortality of hip fractures in the United States.

TL;DR: In the United States, hip fracture rates and subsequent mortality among persons 65 years and older are declining, and comorbidities among patients with hip fractures have increased.
Journal ArticleDOI

Prevention of falls and consequent injuries in elderly people

TL;DR: Care must be taken to rigorously select the right actions for those people most likely to benefit, such as vitamin D and calcium supplementation and hip protectors for elderly people living in institutions.
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Muscle Weakness and Falls in Older Adults: A Systematic Review and Meta-Analysis

TL;DR: The evidence of muscle weakness as a risk factor for falls in older adults is evaluated and the likelihood of falls is summarized.

Falls in older people: risk factors and strategies for prevention.

TL;DR: A physiological profile approach to falls risk assessment and prevention and strategies for prevention - from research into practice are put into practice.
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Risk factors and risk assessment tools for falls in hospital in-patients: a systematic review

TL;DR: A small number of significant falls risk factors emerged consistently, despite the heterogeneity of settings namely gait instability, agitated confusion, urinary incontinence/frequency, falls history and prescription of 'culprit' drugs.
References
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Journal ArticleDOI

A multifactorial intervention to reduce the risk of falling among elderly people living in the community.

TL;DR: The multiple-risk-factor intervention strategy resulted in a significant reduction in the risk of falling among elderly persons in the community and among persons who had the targeted risk factors for falling, as compared with the control group.
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Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women

TL;DR: An individual programme of strength and balance retraining exercises improved physical function and was effective in reducing falls and injuries in women 80 years and older in Dunedin, New Zealand.
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Reducing Frailty and Falls in Older Persons: An Investigation of Tai Chi and Computerized Balance Training

TL;DR: The effects of two exercise approaches, Tai Chi and computerized balance training, on specified primary outcomes (biomedical, functional, and psychosocial indicators of frailty) and secondary outcomes (occurrence of falls) are evaluated.
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The Effects of Exercise on Falls in Elderly Patients: A Preplanned Meta-analysis of the FICSIT Trials

TL;DR: A preplanned meta-analysis of the seven Frailty and Injuries: Cooperative Studies of Intervention Techniques (FICSIT) trials that assessed intervention efficacy in reducing falls and frailty in elderly patients found treatments including exercise for elderly adults reduce the risk of falls.
Journal ArticleDOI

Prevention of falls in the elderly trial (PROFET) : a randomised controlled trial

TL;DR: The study shows that an interdisciplinary approach to this high-risk population can significantly decrease the risk of further falls and limit functional impairment.
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