Brendon Stubbs1, Simone Brefka2, Michael D Denkinger3. 1. B. Stubbs, PT, MSc, MCSP, Faculty of Education and Health, University of Greenwich, Southwood Site, Avery Hill Road, Eltham, London, United Kingdom SE9 2UG. brendonstubbs@hotmail.com. 2. S. Brefka, MD, AGAPLESION Bethesda Clinic, Department of Geriatrics, Ulm University, Ulm, Germany. 3. M.D. Denkinger, MD, Competence Centre of Geriatrics and Aging Research Ulm/Alb-Donau, Ulm, Germany.
Abstract
BACKGROUND: Preventing falls is an international priority. There is a need to synthesize the highest-quality falls prevention evidence in one place for clinicians. PURPOSE: The aim of this study was to conduct an umbrella review of meta-analyses of randomized controlled trials (RCTs) of falls prevention interventions in community-dwelling older adults. DATA SOURCES: The MEDLINE, EMBASE, CINAHL, AMED, BNI, PsycINFO, Cochrane Library, PubMed, and PEDro databases were searched. STUDY SELECTION: Meta-analyses with one pooled analysis containing ≥3 RCTs that investigated any intervention to prevent falls in community-dwelling older adults aged ≥60 years were eligible. Sixteen meta-analyses, representing 47 pooled analyses, were included. DATA EXTRACTION: Two authors independently extracted data. DATA SYNTHESIS: Data were narratively synthesized. The methodological quality of the meta-analyses was moderate. Three meta-analyses defined a fall, and 3 reported adverse events (although minor). There is consistent evidence that exercise reduces falls (including the rate, risk, and odds of falling), with 13/14 pooled analyses (93%) from 7 meta-analyses demonstrating a significant reduction. The methodological quality of meta-analyses investigating exercise were medium/high, and effect sizes ranged from 0.87 (relative risk 95% confidence interval=0.81, 0.94; number of studies=18; number of participants=3,568) to 0.39 (rate ratio 95% confidence interval=0.23, 0.66; number of meta-analyses=6). There is consistent evidence that multifactorial interventions reduce falls (5/6, 83% reported significant reduction). There is conflicting evidence regarding the influence of vitamin D supplementation (7/12, 58.3% reported significant reduction). LIMITATIONS: Meta-analyses often used different methods of analysis, and reporting of key characteristics (eg, participants, heterogeneity, publication bias) was often lacking. There may be some overlap among included meta-analyses. CONCLUSIONS: There is consistent evidence that exercise and individually tailored multifactorial interventions are effective in reducing falls in community-dwelling older adults.
BACKGROUND: Preventing falls is an international priority. There is a need to synthesize the highest-quality falls prevention evidence in one place for clinicians. PURPOSE: The aim of this study was to conduct an umbrella review of meta-analyses of randomized controlled trials (RCTs) of falls prevention interventions in community-dwelling older adults. DATA SOURCES: The MEDLINE, EMBASE, CINAHL, AMED, BNI, PsycINFO, Cochrane Library, PubMed, and PEDro databases were searched. STUDY SELECTION: Meta-analyses with one pooled analysis containing ≥3 RCTs that investigated any intervention to prevent falls in community-dwelling older adults aged ≥60 years were eligible. Sixteen meta-analyses, representing 47 pooled analyses, were included. DATA EXTRACTION: Two authors independently extracted data. DATA SYNTHESIS: Data were narratively synthesized. The methodological quality of the meta-analyses was moderate. Three meta-analyses defined a fall, and 3 reported adverse events (although minor). There is consistent evidence that exercise reduces falls (including the rate, risk, and odds of falling), with 13/14 pooled analyses (93%) from 7 meta-analyses demonstrating a significant reduction. The methodological quality of meta-analyses investigating exercise were medium/high, and effect sizes ranged from 0.87 (relative risk 95% confidence interval=0.81, 0.94; number of studies=18; number of participants=3,568) to 0.39 (rate ratio 95% confidence interval=0.23, 0.66; number of meta-analyses=6). There is consistent evidence that multifactorial interventions reduce falls (5/6, 83% reported significant reduction). There is conflicting evidence regarding the influence of vitamin D supplementation (7/12, 58.3% reported significant reduction). LIMITATIONS: Meta-analyses often used different methods of analysis, and reporting of key characteristics (eg, participants, heterogeneity, publication bias) was often lacking. There may be some overlap among included meta-analyses. CONCLUSIONS: There is consistent evidence that exercise and individually tailored multifactorial interventions are effective in reducing falls in community-dwelling older adults.
Authors: Annlia Paganini-Hill; Dana E Greenia; Shawna Perry; Seyed Ahmad Sajjadi; Claudia H Kawas; Maria M Corrada Journal: Age Ageing Date: 2017-11-01 Impact factor: 10.668
Authors: H Blain; T Masud; P Dargent-Molina; F C Martin; E Rosendahl; N van der Velde; J Bousquet; A Benetos; C Cooper; J A Kanis; J Y Reginster; R Rizzoli; B Cortet; M Barbagallo; K E Dreinhöfer; B Vellas; S Maggi; T Strandberg Journal: J Nutr Health Aging Date: 2016 Impact factor: 4.075
Authors: Husna Ahmad Ainuddin; Muhammad Hibatullah Romli; Tengku Aizan Hamid; Mazatulfazura Sf Salim; Lynette Mackenzie Journal: Front Public Health Date: 2021-04-27
Authors: Angela M H J Mengelers; Vincent R A Moermans; Michel H C Bleijlevens; Hilde Verbeek; Elizabeth Capezuti; Frans Tan; Koen Milisen; Jan P H Hamers Journal: J Clin Nurs Date: 2020-09-11 Impact factor: 4.423
Authors: Joseph M Rimland; Iosief Abraha; Giuseppina Dell'Aquila; Alfonso Cruz-Jentoft; Roy Soiza; Adalsteinn Gudmusson; Mirko Petrovic; Denis O'Mahony; Chris Todd; Antonio Cherubini Journal: PLoS One Date: 2016-08-25 Impact factor: 3.240
Authors: Jennifer L Vincenzo; Colleen Hergott; Lori Schrodt; Subashan Perera; Jennifer Tripken; Tiffany E Shubert; Jennifer S Brach Journal: Front Public Health Date: 2021-06-25