Effectiveness of Non-Pharmacological Interventions to Prevent Falls in Older People

A Systematic Overview. The SENATOR Project ONTOP Series

Joseph M Rimland, Iosief Abraha, Giuseppina Dell'Aquila, Alfonso Cruz-Jentoft, Roy Soiza, Adalsteinn Gudmusson, Mirko Petrovic, Denis O'Mahony, Chris Todd, Antonio Cherubini

Research output: Contribution to journalReview article

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Abstract

BACKGROUND: Falls are common events in older people, which cause considerable morbidity and mortality. Non-pharmacological interventions are an important approach to prevent falls. There are a large number of systematic reviews of non-pharmacological interventions, whose evidence needs to be synthesized in order to facilitate evidence-based clinical decision making.

OBJECTIVES: To systematically examine reviews and meta-analyses that evaluated non-pharmacological interventions to prevent falls in older adults in the community, care facilities and hospitals.

METHODS: We searched the electronic databases Pubmed, the Cochrane Database of Systematic Reviews, EMBASE, CINAHL, PsycINFO, PEDRO and TRIP from January 2009 to March 2015, for systematic reviews that included at least one comparative study, evaluating any non-pharmacological intervention, to prevent falls amongst older adults. The quality of the reviews was assessed using AMSTAR and ProFaNE taxonomy was used to organize the interventions.

RESULTS: Fifty-nine systematic reviews were identified which consisted of single, multiple and multifactorial non-pharmacological interventions to prevent falls in older people. The most frequent ProFaNE defined interventions were exercises either alone or combined with other interventions, followed by environment/assistive technology interventions comprising environmental modifications, assistive and protective aids, staff education and vision assessment/correction. Knowledge was the third principle class of interventions as patient education. Exercise and multifactorial interventions were the most effective treatments to reduce falls in older adults, although not all types of exercise were equally effective in all subjects and in all settings. Effective exercise programs combined balance and strength training. Reviews with a higher AMSTAR score were more likely to contain more primary studies, to be updated and to perform meta-analysis.

CONCLUSIONS: The aim of this overview of reviews of non-pharmacological interventions to prevent falls in older people in different settings, is to support clinicians and other healthcare workers with clinical decision-making by providing a comprehensive perspective of findings.

Original languageEnglish
Article numbere0161579
JournalPloS ONE
Volume11
Issue number8
DOIs
Publication statusPublished - 25 Aug 2016

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Meta-Analysis
systematic review
Databases
Self-Help Devices
Resistance Training
exercise
Patient Education
PubMed
Morbidity
Delivery of Health Care
Education
Mortality
decision making
assistive technologies
patient education
strength training
Decision making
health care workers
meta-analysis
electronics

Keywords

  • Accidental Falls
  • Aged
  • Aged, 80 and over
  • Clinical Decision-Making
  • Decision Support Systems, Clinical
  • Evidence-Based Medicine
  • Exercise
  • Exercise Therapy
  • Hospitals
  • Humans
  • Independent Living
  • Nursing Homes
  • Treatment Outcome
  • Journal Article
  • Meta-Analysis
  • Review

Cite this

Effectiveness of Non-Pharmacological Interventions to Prevent Falls in Older People : A Systematic Overview. The SENATOR Project ONTOP Series. / Rimland, Joseph M; Abraha, Iosief; Dell'Aquila, Giuseppina; Cruz-Jentoft, Alfonso; Soiza, Roy; Gudmusson, Adalsteinn; Petrovic, Mirko; O'Mahony, Denis; Todd, Chris; Cherubini, Antonio.

In: PloS ONE, Vol. 11, No. 8, e0161579, 25.08.2016.

Research output: Contribution to journalReview article

Rimland, JM, Abraha, I, Dell'Aquila, G, Cruz-Jentoft, A, Soiza, R, Gudmusson, A, Petrovic, M, O'Mahony, D, Todd, C & Cherubini, A 2016, 'Effectiveness of Non-Pharmacological Interventions to Prevent Falls in Older People: A Systematic Overview. The SENATOR Project ONTOP Series', PloS ONE, vol. 11, no. 8, e0161579. https://doi.org/10.1371/journal.pone.0161579
Rimland, Joseph M ; Abraha, Iosief ; Dell'Aquila, Giuseppina ; Cruz-Jentoft, Alfonso ; Soiza, Roy ; Gudmusson, Adalsteinn ; Petrovic, Mirko ; O'Mahony, Denis ; Todd, Chris ; Cherubini, Antonio. / Effectiveness of Non-Pharmacological Interventions to Prevent Falls in Older People : A Systematic Overview. The SENATOR Project ONTOP Series. In: PloS ONE. 2016 ; Vol. 11, No. 8.
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abstract = "BACKGROUND: Falls are common events in older people, which cause considerable morbidity and mortality. Non-pharmacological interventions are an important approach to prevent falls. There are a large number of systematic reviews of non-pharmacological interventions, whose evidence needs to be synthesized in order to facilitate evidence-based clinical decision making.OBJECTIVES: To systematically examine reviews and meta-analyses that evaluated non-pharmacological interventions to prevent falls in older adults in the community, care facilities and hospitals.METHODS: We searched the electronic databases Pubmed, the Cochrane Database of Systematic Reviews, EMBASE, CINAHL, PsycINFO, PEDRO and TRIP from January 2009 to March 2015, for systematic reviews that included at least one comparative study, evaluating any non-pharmacological intervention, to prevent falls amongst older adults. The quality of the reviews was assessed using AMSTAR and ProFaNE taxonomy was used to organize the interventions.RESULTS: Fifty-nine systematic reviews were identified which consisted of single, multiple and multifactorial non-pharmacological interventions to prevent falls in older people. The most frequent ProFaNE defined interventions were exercises either alone or combined with other interventions, followed by environment/assistive technology interventions comprising environmental modifications, assistive and protective aids, staff education and vision assessment/correction. Knowledge was the third principle class of interventions as patient education. Exercise and multifactorial interventions were the most effective treatments to reduce falls in older adults, although not all types of exercise were equally effective in all subjects and in all settings. Effective exercise programs combined balance and strength training. Reviews with a higher AMSTAR score were more likely to contain more primary studies, to be updated and to perform meta-analysis.CONCLUSIONS: The aim of this overview of reviews of non-pharmacological interventions to prevent falls in older people in different settings, is to support clinicians and other healthcare workers with clinical decision-making by providing a comprehensive perspective of findings.",
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author = "Rimland, {Joseph M} and Iosief Abraha and Giuseppina Dell'Aquila and Alfonso Cruz-Jentoft and Roy Soiza and Adalsteinn Gudmusson and Mirko Petrovic and Denis O'Mahony and Chris Todd and Antonio Cherubini",
note = "Funding: This work was supported by the European Union Seventh Framework program (FP7/2007–2013) under grant agreement n° 305930 (SENATOR; http://www.senator-project.eu/) and by the ICT PSP (Policy Support Program) as part of the Competitiveness and Innovation Framework Program of the EU under grant agreement n° 325087 (ProFouND; http://profound.eu.com/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.",
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T1 - Effectiveness of Non-Pharmacological Interventions to Prevent Falls in Older People

T2 - A Systematic Overview. The SENATOR Project ONTOP Series

AU - Rimland, Joseph M

AU - Abraha, Iosief

AU - Dell'Aquila, Giuseppina

AU - Cruz-Jentoft, Alfonso

AU - Soiza, Roy

AU - Gudmusson, Adalsteinn

AU - Petrovic, Mirko

AU - O'Mahony, Denis

AU - Todd, Chris

AU - Cherubini, Antonio

N1 - Funding: This work was supported by the European Union Seventh Framework program (FP7/2007–2013) under grant agreement n° 305930 (SENATOR; http://www.senator-project.eu/) and by the ICT PSP (Policy Support Program) as part of the Competitiveness and Innovation Framework Program of the EU under grant agreement n° 325087 (ProFouND; http://profound.eu.com/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

PY - 2016/8/25

Y1 - 2016/8/25

N2 - BACKGROUND: Falls are common events in older people, which cause considerable morbidity and mortality. Non-pharmacological interventions are an important approach to prevent falls. There are a large number of systematic reviews of non-pharmacological interventions, whose evidence needs to be synthesized in order to facilitate evidence-based clinical decision making.OBJECTIVES: To systematically examine reviews and meta-analyses that evaluated non-pharmacological interventions to prevent falls in older adults in the community, care facilities and hospitals.METHODS: We searched the electronic databases Pubmed, the Cochrane Database of Systematic Reviews, EMBASE, CINAHL, PsycINFO, PEDRO and TRIP from January 2009 to March 2015, for systematic reviews that included at least one comparative study, evaluating any non-pharmacological intervention, to prevent falls amongst older adults. The quality of the reviews was assessed using AMSTAR and ProFaNE taxonomy was used to organize the interventions.RESULTS: Fifty-nine systematic reviews were identified which consisted of single, multiple and multifactorial non-pharmacological interventions to prevent falls in older people. The most frequent ProFaNE defined interventions were exercises either alone or combined with other interventions, followed by environment/assistive technology interventions comprising environmental modifications, assistive and protective aids, staff education and vision assessment/correction. Knowledge was the third principle class of interventions as patient education. Exercise and multifactorial interventions were the most effective treatments to reduce falls in older adults, although not all types of exercise were equally effective in all subjects and in all settings. Effective exercise programs combined balance and strength training. Reviews with a higher AMSTAR score were more likely to contain more primary studies, to be updated and to perform meta-analysis.CONCLUSIONS: The aim of this overview of reviews of non-pharmacological interventions to prevent falls in older people in different settings, is to support clinicians and other healthcare workers with clinical decision-making by providing a comprehensive perspective of findings.

AB - BACKGROUND: Falls are common events in older people, which cause considerable morbidity and mortality. Non-pharmacological interventions are an important approach to prevent falls. There are a large number of systematic reviews of non-pharmacological interventions, whose evidence needs to be synthesized in order to facilitate evidence-based clinical decision making.OBJECTIVES: To systematically examine reviews and meta-analyses that evaluated non-pharmacological interventions to prevent falls in older adults in the community, care facilities and hospitals.METHODS: We searched the electronic databases Pubmed, the Cochrane Database of Systematic Reviews, EMBASE, CINAHL, PsycINFO, PEDRO and TRIP from January 2009 to March 2015, for systematic reviews that included at least one comparative study, evaluating any non-pharmacological intervention, to prevent falls amongst older adults. The quality of the reviews was assessed using AMSTAR and ProFaNE taxonomy was used to organize the interventions.RESULTS: Fifty-nine systematic reviews were identified which consisted of single, multiple and multifactorial non-pharmacological interventions to prevent falls in older people. The most frequent ProFaNE defined interventions were exercises either alone or combined with other interventions, followed by environment/assistive technology interventions comprising environmental modifications, assistive and protective aids, staff education and vision assessment/correction. Knowledge was the third principle class of interventions as patient education. Exercise and multifactorial interventions were the most effective treatments to reduce falls in older adults, although not all types of exercise were equally effective in all subjects and in all settings. Effective exercise programs combined balance and strength training. Reviews with a higher AMSTAR score were more likely to contain more primary studies, to be updated and to perform meta-analysis.CONCLUSIONS: The aim of this overview of reviews of non-pharmacological interventions to prevent falls in older people in different settings, is to support clinicians and other healthcare workers with clinical decision-making by providing a comprehensive perspective of findings.

KW - Accidental Falls

KW - Aged

KW - Aged, 80 and over

KW - Clinical Decision-Making

KW - Decision Support Systems, Clinical

KW - Evidence-Based Medicine

KW - Exercise

KW - Exercise Therapy

KW - Hospitals

KW - Humans

KW - Independent Living

KW - Nursing Homes

KW - Treatment Outcome

KW - Journal Article

KW - Meta-Analysis

KW - Review

U2 - 10.1371/journal.pone.0161579

DO - 10.1371/journal.pone.0161579

M3 - Review article

VL - 11

JO - PloS ONE

JF - PloS ONE

SN - 1932-6203

IS - 8

M1 - e0161579

ER -