Falls preventable in over 65s

A large-scale international review involving University of Sydney researchers has shed light on falls in older people, revealing interventions can prevent falls in over 65s and living in their own homes.


The review, published in the "Cochrane Database of Systematic Reviews", included 159 trials involving more than 79,000 participants from Australia, the UK and New Zealand and was co-authored by The University of Sydney’s Professor Lindy Clemson, Faculty of Health Sciences and Associate Professor Cathie Sherrington, George Institute for Global Health.


The research was led by the University of Otago in New Zealand, and also involved researchers from the University of Hull and the University of Warwick in the UK.


“Falls have debilitating and isolating social consequences for older people, not to mention the increasing economic cost they present in our ageing population,” says Professor Clemson.


“Our review found a number of interventions can prevent older people from falling, with solutions as simple as wearing an anti-slip shoe device in icy conditions and as complex as surgical and drug treatments. We found multiple-component exercises for groups or individuals significantly reduced the risk of falls.”


In fact, three trials in the review found that interventions could save more money than they cost.


Falls affect approximately 30 percent of people over 65 living in the community. Around one in five falls requires medical attention, and one in ten results in a fracture.


“Falls can start a downward spiral of immobility, reduced confidence, and incapacity leading to institutionalisation, so it’s really important we tackle the issue to prevent as many falls as possible,” says Professor Clemson, who developed a program for falls prevention published in the "British Medical Journal" last month.


The Cochrane review found performing safety modifications and behaviour changes in the home to be particularly effective in falls reduction, especially for people with severe visual impairments and when the assessment was carried out by a qualified occupational therapist.


Some forms of medication changes and surgery also reduced falling, with people fitted for pacemakers for particular heart rate disorders (carotid sinus hypersensitivity) falling less often than those without the pacemakers. Women receiving cataract surgery on the first eye also had a reduced rate of falling, although removing the cataract from the second eye had no further effect.


According to the review, older people may be at an increased risk of falling while adjusting to new glasses or major changes in prescriptions. However, the risk reduced when people wearing multifocal glasses who took part in activities outside the home swapped their multifocals for two separate pairs of glasses for distance and close vision tasks.


12 September 2012.