Effectiveness of fall prevention interventions in residential aged care and community settings: an umbrella review.

Meulenbroeks, I; Mercado, C; Gates, P; Nguyen, A; Seaman, K; Wabe, N; Silva, SM; Zheng, WY; Debono, D; Westbrook, J

Effectiveness of fall prevention interventions in residential aged care and community settings: an umbrella review.

Meulenbroeks, I Mercado, C Gates, P Nguyen, A Seaman, K Wabe, N Silva, SM Zheng, WY Debono, D

Westbrook, J

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Publisher:: BMC
Publication Type:: Journal Article
Citation:: BMC Geriatr, 2024, 24, (1), pp. 75
Issue Date:: 2024-01-19

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Field	Value	Language
dc.contributor.author	Meulenbroeks, I
dc.contributor.author	Mercado, C
dc.contributor.author	Gates, P
dc.contributor.author	Nguyen, A
dc.contributor.author	Seaman, K
dc.contributor.author	Wabe, N
dc.contributor.author	Silva, SM
dc.contributor.author	Zheng, WY
dc.contributor.author	Debono, D https://orcid.org/0000-0003-2095-156X
dc.contributor.author	Westbrook, J
dc.date.accessioned	2024-08-01T03:27:56Z
dc.date.available	2023-12-18
dc.date.available	2024-08-01T03:27:56Z
dc.date.issued	2024-01-19
dc.identifier.citation	BMC Geriatr, 2024, 24, (1), pp. 75
dc.identifier.issn	1471-2318
dc.identifier.issn	1471-2318
dc.identifier.uri	http://hdl.handle.net/10453/179895
dc.description.abstract	INTRODUCTION: Preventing falls is a priority for aged care providers. Research to date has focused on fall prevention strategies in single settings (e.g., residential aged care (RAC) or community settings). However, some aged care providers deliver care, including fall prevention interventions, across RAC and community settings. We conducted an umbrella review to identify what type of fall prevention interventions had the greatest impact on falls outcomes in RAC and community settings. METHODS: Five databases were searched for systematic reviews of falls prevention randomised control trials in older adults living in the community or RAC. Data extracted included systematic review methods, population characteristics, intervention characteristics, setting details (RAC or community), and fall-related outcomes (falls, people who have had a fall, fall-related hospitalisations, and fall-related fractures). Review quality was appraised using the Assessment of Multiple Systematic Reviews-2 tool. RESULTS: One-hundred and six systematic reviews were included; 63 and 19 of these stratified results by community and RAC settings respectively, the remainder looked at both settings. The most common intervention types discussed in reviews included 'exercise' (61%, n = 65), 'multifactorial' (two or more intervention types delivered together) (26%, n = 28), and 'vitamin D' (18%, n = 19). In RAC and community settings, 'exercise' interventions demonstrated the most consistent reduction in falls and people who have had a fall compared to other intervention types. 'Multifactorial' interventions were also beneficial in both settings however demonstrated more consistent reduction in falls and people who fall in RAC settings compared to community settings. 'Vitamin D' interventions may be beneficial in community-dwelling populations but not in RAC settings. It was not possible to stratify fall-related hospitalisation and fall-related fracture outcomes by setting due to limited number of RAC-specific reviews (n = 3 and 0 respectively). CONCLUSION: 'Exercise' interventions may be the most appropriate falls prevention intervention for older adults in RAC and community settings as it is beneficial for multiple fall-related outcomes (falls, fall-related fractures, and people who have had a fall). Augmenting 'exercise' interventions to become 'multifactorial' interventions may also improve the incidence of falls in both settings.
dc.format	Electronic
dc.language	eng
dc.publisher	BMC
dc.relation.ispartof	BMC Geriatr
dc.relation.isbasedon	10.1186/s12877-023-04624-4
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1103 Clinical Sciences, 1106 Human Movement and Sports Sciences
dc.subject.classification	Geriatrics
dc.subject.classification	3202 Clinical sciences
dc.subject.classification	4203 Health services and systems
dc.subject.classification	4206 Public health
dc.subject.mesh	Aged
dc.subject.mesh	Humans
dc.subject.mesh	Fractures, Bone
dc.subject.mesh	Systematic Reviews as Topic
dc.subject.mesh	Vitamin D
dc.subject.mesh	Vitamins
dc.subject.mesh	Humans
dc.subject.mesh	Vitamins
dc.subject.mesh	Vitamin D
dc.subject.mesh	Aged
dc.subject.mesh	Fractures, Bone
dc.subject.mesh	Systematic Reviews as Topic
dc.subject.mesh	Aged
dc.subject.mesh	Humans
dc.subject.mesh	Fractures, Bone
dc.subject.mesh	Systematic Reviews as Topic
dc.subject.mesh	Vitamin D
dc.subject.mesh	Vitamins
dc.title	Effectiveness of fall prevention interventions in residential aged care and community settings: an umbrella review.
dc.type	Journal Article
utslib.citation.volume	24
utslib.location.activity	England
utslib.for	1103 Clinical Sciences
utslib.for	1106 Human Movement and Sports Sciences
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/Faculty of Health/Public Health
pubs.organisational-group	University of Technology Sydney/All Manual Groups
pubs.organisational-group	University of Technology Sydney/All Manual Groups/UTS Ageing Research Collaborative (UARC)
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2024-08-01T03:27:55Z
pubs.issue	1
pubs.publication-status	Published online
pubs.volume	24
utslib.citation.issue	1

Abstract:

INTRODUCTION: Preventing falls is a priority for aged care providers. Research to date has focused on fall prevention strategies in single settings (e.g., residential aged care (RAC) or community settings). However, some aged care providers deliver care, including fall prevention interventions, across RAC and community settings. We conducted an umbrella review to identify what type of fall prevention interventions had the greatest impact on falls outcomes in RAC and community settings. METHODS: Five databases were searched for systematic reviews of falls prevention randomised control trials in older adults living in the community or RAC. Data extracted included systematic review methods, population characteristics, intervention characteristics, setting details (RAC or community), and fall-related outcomes (falls, people who have had a fall, fall-related hospitalisations, and fall-related fractures). Review quality was appraised using the Assessment of Multiple Systematic Reviews-2 tool. RESULTS: One-hundred and six systematic reviews were included; 63 and 19 of these stratified results by community and RAC settings respectively, the remainder looked at both settings. The most common intervention types discussed in reviews included 'exercise' (61%, n = 65), 'multifactorial' (two or more intervention types delivered together) (26%, n = 28), and 'vitamin D' (18%, n = 19). In RAC and community settings, 'exercise' interventions demonstrated the most consistent reduction in falls and people who have had a fall compared to other intervention types. 'Multifactorial' interventions were also beneficial in both settings however demonstrated more consistent reduction in falls and people who fall in RAC settings compared to community settings. 'Vitamin D' interventions may be beneficial in community-dwelling populations but not in RAC settings. It was not possible to stratify fall-related hospitalisation and fall-related fracture outcomes by setting due to limited number of RAC-specific reviews (n = 3 and 0 respectively). CONCLUSION: 'Exercise' interventions may be the most appropriate falls prevention intervention for older adults in RAC and community settings as it is beneficial for multiple fall-related outcomes (falls, fall-related fractures, and people who have had a fall). Augmenting 'exercise' interventions to become 'multifactorial' interventions may also improve the incidence of falls in both settings.

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http://hdl.handle.net/10453/179895