Loading...
 
Toggle Health Problems and D

Fall prevention - Vitamin D is one of the ways - umbrella review Jan 2024

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

BMC Geriatr. 2024 Jan 19;24(1):75. doi: 10.1186/s12877-023-04624-4.
Isabelle Meulenbroeks 1, Crisostomo Mercado 2, Peter Gates 2 3, Amy Nguyen 2 4, Karla Seaman 2, Nasir Wabe 2, Sandun M Silva 2, Wu Yi Zheng 5, Deborah Debono 6, Johanna Westbrook 2

Subset of table in PDF
Image
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.
 Download the PDF from Vitamin D Life

67 References
  1. Waldron N, Hill A-M, Barker A. falls prevention In older adults: assessment and management. Aust Fam Physician. 2012;41(12):930-5.
  2. Watson W, Clapperton A, Mitchell R. The burden of fall-related injury among older persons in New South Wales. Aust N Z J Public Health. 2011;35(2):170-5. https://doi.org/10.! 111/j.1753-6405.2010.00656.x.
  3. Australian Institute of Health and Welfare. falls. Canberra: AIHW; 2022.
  4. Royal Australian College of General Practitioners: National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people. 2022. https://www.racgp.org.au/clinical-resources/clinical-guide lines/key-racgp-guidelines/view-all-racgp-guidelines/national-guide/ chapter-5-the-health-of-older-people/falls. Accessed 8 Nov 2022.
  5. Vlaeyen E, Coussement J, Leysens G, Van der Elst E, Delbaere K, Cambier D, Denhaerynck K, Goemaere S, Wertelaers A, Dobbels F. Characteristics and effectiveness of fall prevention programs in nursing homes: a sys­tematic review and meta-analysis of randomized controlled trials. J Am Geriatr Soc. 2015;63(2):211-21. https://doi.org/104 111/jgs.13254.
  6. Australian Commission on Safety and Quality in Health Care. Prevent­ing falls and harm from falls in older people: best practice guidelines for Australian residential aged care facilities. Edited by Healthcare ACoSaQi. Canberra, Australia: ACSQH; 2009.
  7. World Health Organisation. What are the main risk factors for falls amongst older people and what are the most effective interventions to
  8. prevent these falls? 2004. https://www.euro.who.int/data/assets/pdf_ file/0018/74700/E82552.pdf. Accessed 18 May 2022.
  9. Burns E, Kakara R. Deaths from falls among persons aged >65 years - United States, 2007-2016. MMWR Morb Mortal Wkly Rep. 2018;67(18):509-14. https://doi.org/10.15585/mmwr.mm6718a 1.
  10. Tinetti ME, Williams CS. falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med. 1997;337(18):1279-84. https://doi.org/10.1056/NEJM199710303371806.
  11. Australian Institute of Health and Welfare. Injury expenditure in Australia 2015-16. Canberra, Australia: AIHW; 2020.
  12. Australian Institute of Health and Welfare. falls in older Australians 2019-20: hospitalisations and deaths among people aged 65 and over. Canberra, Australia: AIHW; 2022.
  13. Sherrington C, Michaleff ZA, Fairhall N, Paul SS, Tiedemann A, Whitney J, Cumming RG, Herbert RD, Close JCT, Lord SR. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis.
  14. Br J Sports Med. 2017;51(24):1749-57. https://doi.org/104 136/bjspo rts-2016-096547.
  15. Cameron ID, Dyer SM, Panagoda CE, Murray GR, Hill KD, Cumming RG, Kerse N. Interventions for preventing falls in older people in care facili­ties and hospitals. Cochrane Database Syst Rev. 2018;9(9):CD005465- CD005465. https://doi.org/10.1002/14651858.cd005465.pub4.
  16. Pighills A, Drummond A, Crossland S, Torgerson DJ. What type of envi­ronmental assessment and modification prevents falls in community dwelling older people? BMJ. 2019;364:l880. https://doi.org/10.1136/bmj. l880.
  17. Hopewell S, Adedire O, Copsey BJ, Boniface GJ, Sherrington C, Clemson L, et al. Multifactorial and multiple component interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2018;7 https://doi.org/10.1002/14651858.cd012221 .pub2.
  18. Gillespie LD, Robertson MC, Gillespie WJ, Sherrington C, Gates S, Clemson L, et al. Interventions for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2012;9 https://doi.org/10.1002/ 14651858.cd007146.pub3.
  19. Panel on prevention of falls in older persons AGSaBGS. Summary of the updated American Geriatrics Society/British geriatrics society clinical practice guideline for prevention of falls in older persons. J Am Geriatr Soc. 2011;59(1):148-57. https://doi.org/104 111/j.1532-5415.2010.03234.x.
  20. Sherrington C, Fairhall NJ, Wallbank GK, Tiedemann A, Michaleff ZA, Howard K, Clemson L, Hopewell S, Lamb SE. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019;1:CD012424. https://doi.org/10.1002/14651858.cd012424.pub2.
  21. Institute JB. In: Aromataris E, Munn Z, editors. JBI manual for evidence synthesis. Adelaide, Australia: JBI; 2020.
  22. Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF. Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement. Lancet. 1999;354(9193):1896-900.
  23. Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan—a web and mobile app for systematic reviews. Syst Rev. 2016;5(1):210. https:// doi.org/10.1186/s 13643-016-0384-4.
  24. Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, Moher D,Tugwell P, Welch V, Kristjansson E, Henry DA. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008. https:// doi.org/10.1136/bmj.j4008.
  25. AMSTAR. AMSTAR 2 - the new and improved AMSTAR. 2021. https:// amstar.ca/Amstar-2.php. Access date 26 July 2023.
  26. Gulka HJ, Patel V, Arora T, McArthur C, Iaboni A. Efficacy and generalizabil- ity of falls prevention interventions in nursing homes: a systematic review and meta-analysis. J Am Med Dir Assoc. 2020;21(8):1024-1024. https:// doi.org/10.1016/j.jamda.2019.11.012.
  27. Tricco AC, Thomas SM, Veroniki AA, Hamid JS, Cogo E, Strifler L, Khan PA, Sibley KM, Robson R, MacDonald H, Riva JJ, Thavorn K, Wilson C, Holroyd-Leduc J, Kerr GD, Feldman F, Majumdar SR, Jaglal SB, Hui W, Straus SE. Quality improvement strategies to prevent falls in older
  28. Dautzenberg L, Beglinger S, Tsokani S, Zevgiti S, Raijmann RCMA, Rodondi N, Scholten RJPM, Rutjes AWS, Di Nisio M, Emmelot-Vonk M, Tricco AC, Straus SE, Thomas S, Bretagne L, Knol W, Mavridis D, Koek HL. Interven­tions for preventing falls and fall-related fractures in community-dwelling older adults: a systematic review and network meta-analysis. J Am Geriatr Soc. 2021;69(10):2973-84. https://doi.org/10.11 11/jgs.17375.
  29. Guo J-L, Tsai Y-Y, Liao J-Y, Tu H-M, Huang C-M. Interventions to reduce the number of falls among older adults with7without cognitive impairment: an exploratory meta-analysis. Int J Geriatr Psychiatry. 2014;29(7):661-9. https://doi.org/10.1002/gps.4056.
  30. Wang F, Tian B. The effectiveness of physical exercise type and length to prevent falls in nursing homes: a systematic review and meta-analysis. J Clin Nurs. 2022;31(1-2):32-42. https://doi.org/10.1111/jocn.15942.
  31. Wu H, Pang Q. The effect of vitamin D and calcium supplementation on falls in older adults: a systematic review and meta-analysis. Orthopade. 2017;46(9):729-36. https://doi.org/10.1007/s00132-017-3446-y.
  32. Haines TP, D-CA L, Etherton-Beer C, McPhail S, Morris ME, Flicker L, Netto J, Francis-Coad J, Shorr R, Naseri C, Hill A-M. Reducing falls in older adults recently discharged from hospital: a systematic review and meta-analysis. Age Ageing. 2018;47(4):512-9. https://doi.org/10.1093/ageing/afy043.
  33. Guirguis-Blake JM, Michael YL, Perdue LA, Coppola EL, Beil TL. Interven­tions to prevent falls in older adults: updated evidence report and systematic review for the US preventive services task force. JAMA. 2018;319(16):1705-16. https://doi.org/10.1001/jama.2017.21962.
  34. Li F, Harmer P Eckstrom E, Ainsworth BE, Fitzgerald K, Voit J, Chou L-S, Welker FL, Needham S. Efficacy of exercise-based interventions in pre­venting falls among community-dwelling older persons with cognitive impairment: is there enough evidence? An updated systematic review and meta-analysis. Age Ageing. 2021;50(5):1557-68. https://doi.org/10. 1093/ageing/afab110.
  35. Thomas S, Mackintosh S, Halbert J. Does the 'Otago exercise programme' reduce mortality and falls in older adults? A systematic review and meta­analysis. Age Ageing. 2010;39(6):681-7. https://doi.org/10.1093/ageing/ afq102.
  36. Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, Orav JE, Stuck AE, Theiler R, Wong JB, Egli A, Kiel DP Henschkowski J. fall prevention with supplemental and active forms of vitamin D: a meta-analysis of ran­domised controlled trials. BMJ. 2009;339:b3692. https://doi.org/104 136/ bmj.b3692.
  37. Barreto PS, Maltais M, Rosendahl E, Vellas B, Bourdel-Marchasson I, Lamb SE, Pitkala K, Roll Y, de Souto Barreto P. Exercise effects on falls, frac­tures, hospitalizations, and mortality in older adults with dementia: an individual-level patient data meta-analysis. J Gerontol - Biol Sci Med Sci. 2021;76(9):e203-12. https://doi.org/10.1093/gerona/glaa307.
  38. Almutairi H, Stafford A, Etherton-Beer C, Flicker L. Optimisation of medications used in residential aged care facilities: a systematic review and meta-analysis of randomised controlled trials. BMC Geriatr. 2020;20(1):1-19.
  39. Garcia-Hermoso A, Ramirez-Velez R, Saez de Asteasu ML, Martinez-Velilla N, Zambom-Ferraresi F, Izquierdo M, Valenzuela PL, Lucia A. Safety and effectiveness of long-term exercise interventions in older adults: a sys­tematic review and meta-analysis of randomized controlled trials. Sports Med. 2020;50(6):1095-106.
  40. Maltais M, De Souto BP Roll Y, Vellas B. Association of long-term exercise training with risk of falls, fractures, hospitalizations, and mortality in older adults: a systematic review and meta-analysis. JAMA Intern Med. 2019;179(3):394-405. https://doi.org/10.1001/jamainternmed.2018.5406.
  41. Mayo-Wilson E, Grant S, Burton J, Parsons A, Underhill K, Montgomery P. Preventive home visits for mortality, morbidity, and institutionalization in older adults: a systematic review and meta-analysis. PLoS One. 2014;9(3) https://doi.org/10.1371/journal.pone.0089257.
  42. Zheng YT, Cui QQ, Hong YM, Yao WG. A meta-analysis of high dose, intermittent vitamin D supplementation among older adults. PLoS One. 2015;10(1) https://doi.org/10.1371/journal.pone.0115850.
  43. Kua C-H, Mak VSL, Huey Lee SW. Health outcomes of deprescribing inter­ventions among older residents in nursing homes: a systematic review and meta-analysis. J Am Med Dir Assoc. 2019;20(3):362-362. https://doi. org/10.1016/j.jamda.2018.10.026.
  44. Australian Commission on Safety and Quality in Healthcare. Preventing falls and harm from falls in older people: best practice guidelines for adults: a systematic review and network meta-analysis. Age Ageing. 2019;48(3):337-46. https://doi.org/10.1093/ageing/afy219.
  45. Okubo Y, Schoene D, Lord SR. Step training improves reaction time, gait and balance and reduces falls in older people: a systematic review and meta-analysis. Br J Sports Med. 2017;51(7):586-93. https://doi.org/10.1136/bjsports-2015-095452.
  46. Schoberer D, Breimaier HE. Meta-analysis and GRADE profiles of exercise interventions for falls prevention in long-term care facilities. J Adv Nurs. 2020;76(1):121-34. https://doi.org/10.1111/jan.14238.
  47. Hopewell S, Copsey B, Nicolson P Adedire B, Boniface G, Lamb S. Multi­factorial interventions for preventing falls in older people living in the community: a systematic review and meta-analysis of 41 trials and almost 20 000 participants. Br J Sports Med. 2019; https://doi.org/10.1136/bjspo rts-2019-100732.
  48. Milisen K, Vlaeyen E, Coussement J, Leysens G, Van Der Elst E, Delbaere K, Cambier D, Denhaerynck K, Dejaeger E, Boonen S. Characteristics and effectiveness of fall prevention programs in nursing homes: a systematic review and meta-analysis of randomized controlled trials. J Am Geriatr Soc. 2013;4:S54. https://doi.org/! 0.1111 /jgs.13254.
  49. Norgaard JE, Jorgensen MG, Ryg J, Andreasen J, Danielsen MB, Steiner DK, Andersen S. Effects of gait adaptability training on falls and fall-related frac­tures in older adults: a systematic review and meta-analysis. Age Ageing. 2021;50(6):1914-24. https://doi.org/10.1093/ageing/afab105.
  50. Beswick AD, Rees K, Ayis S, Gooberman-Hill R, Horwood J, Dieppe P Ebrahim S. Complex interventions to improve physical function and maintain independent living in elderly people: a systematic review and meta-analysis. Lancet. 2008;371(9614):725-35. https://doi.org/10.1016/ s0140-6736(08)60342-6.
  51. Thanapluetiwong S, Chewcharat A, Takkavatakarn K, Praditpornsilpa K, Eiam-Ong S, Susantitaphong P. Vitamin D supplement on preven­tion of fall and fracture: a meta-analysis of randomized controlled trials. Medicine. 2020;99(34):e21506. https://doi.org/10.1097/md.0000000000 021506.
  52. Wong RMY, Chong KC, Law SW, Ho WT, Li J, Chui CS, Chow SKH, Cheung WH. The effectiveness of exercises on fall and fracture prevention amongst community elderlies: a systematic review and meta-analysis. J Orthop. 2020;24:58-65. https://doi.org/10.1016/j.jot.2020.05.007.
  53. Kalyani RR, Stein B, Valiyil R, Manno R, Maynard JW, Crews DC. Vitamin D treatment for the prevention of falls in older adults: systematic review and meta-analysis. J Am Geriatr Soc. 2010;58(7):1299-310. https://doi. org/10.1111 /j.1532-5415.2010.02949.x.
  54. Sherrington C, Fairhall N, Kwok W, Wallbank G, Tiedemann A, Michaleff ZA, et al. Evidence on physical activity and falls prevention for people aged 65+ years: systematic review to inform the WHO guidelines on physical activity and sedentary behaviour. Int J Behav Nutr Phys Act. 2020;(1) N.PAG-N.PAG:17. https://doi.org/10.1186/s12966-020-01041-3.
  55. Sibley KM, Thomas SM, Veroniki AA, Rodrigues M, Hamid JS, Lachance CC, et al. Comparative effectiveness of exercise interventions for prevent­ing falls in older adults: a secondary analysis of a systematic review with network meta-analysis. Exp Gerontol. 2021:143. https://doi.org/10.1016/j. exger.2020.111151.
  56. Murad MH, Elamin KB, Abu Elnour NO, Elamin MB, Alkatib AA, Fatoure- chi MM, Almandoz JP Mullan RJ, Lane MA, Liu H, Erwin PJ, Hensrud DD,
  57. Montori VM. Clinical review: the effect of vitamin D on falls: a systematic 54. review and meta-analysis. J Clin Endocrinol Metab. 2011;96(10):2997-3006. https://doi.org/10.1210/jc.2011 -1193.
  58. Lee SH, Yu S. Effectiveness of multifactorial interventions in preventingfalls among older adults in the community: a systematic review and meta-analysis. Int J Nurs Stud. 2020;106:N.PAG-N.PAG https://doi.org/10. 1016/j.ijnurstu.2020.103564.
  59. Lee SH, Kim HS. Exercise interventions for preventing falls among older people in care facilities: a meta-analysis. Worldviews Evid-Based Nurs. 56. 2017;14(1):74-80. https://doi.org/10.1111 /wvn.12193.
  60. Herbert RD, Cumming RG, Lord SR, Whitney JC, Close JCT, Sherrington C. Effective exercise for the prevention of falls: a systematic review and 57.
  61. meta-analysis. J Am Geriatr Soc. 2008;56(12):2234-43. https://doi.org/10.1111 /j.1532-5415.2008.02014.x.
  62. Zhang XY, Shuai J, Li LP Vision and relevant risk factor interventions for preventing falls among older people: a network meta-analysis. Sci Rep. 58.
  63. Australian community care. Edited by Healthcare ACoSaQi. Canberra, Australia: ACSQH; 2009.
  64. Walker P Kifley A, Kurrle S, Cameron ID. Increasing the uptake of vitamin D supplement use in Australian residential aged care facilities: results from the vitamin D implementation (ViDAus) study. BMC Geriatr. 2020;20(1):383. https://doi.org/10.1186/s12877-020-01784-5.
  65. Australian Institute of Health and Welfare. Physical activity. Canberra, Australia: AIHW; 2023.
  66. World Health Organisation. Physical activity. 2022. https://www.who.int/ news-room/fact-sheets/detail/physical-activity. Accessed 26 July 2023.
  67. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE. The PRISMA 2020 state­ment: an updated guideline for reporting systematic reviews. BMJ. 2021;88:105906. https://doi.org/10.1136/bmj.n71.

Vitamin D Life – Falls and Fractures category contains:

Falls

Fracture


Fall prevention - Vitamin D is one of the ways - umbrella review Jan 2024        
472 visitors, last modified 20 Jan, 2024,
Printer Friendly Follow this page for updates
Falls and Fractures 253
Page actions
Print
Edit Files 2

Attached files

ID Name Comment Uploaded Size Downloads
20683 fall prevention community.png admin 20 Jan, 2024 51.50 Kb 66
20682 fall prevention umbrella_CompressPdf.pdf admin 20 Jan, 2024 922.51 Kb 44