The effects of fall prevention trials on depressive symptoms and fear of falling among the aged: a systematic review.

Firstly, to explore whether depressive symptoms and fear of falling have been used as outcome measures in fall prevention trials. Secondly, to determine the effects of fall prevention trials on these variables among the aged. A literature search covering various medical databases was conducted to identify randomised controlled trials regarding the effects of fall prevention programmes on depressive symptoms and fear of falling among the aged. The studies were classified according to the intervention method (single/multifactorial) and study results (positive/negative) regarding depressive symptoms or fear of falling. Methodological quality was assessed in relation to blinding at outcome assessment, follow-up and whether intention-to-treat analysis was used. Depressive symptoms were used as an outcome measure in eight and fear of falling in 21 studies. A multifactorial approach seems the most effective method in reducing fear of falling, while some single methods such as Tai Chi also seem beneficial. Little evidence was found relating to the effects of fall prevention trials on depressive symptoms. Fear of falling may be reduced by fall prevention programmes. More studies assessing the effects on depressive symptoms, especially among the depressed aged are needed.