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SOURCE: Tricco AC, Thomas SM, Veroniki AA, et al. Comparisons of interventions for preventing falls in older adults: A systematic review and meta-analysis. JAMA 2017;318:1687-1699.
Most clinicians recognize the serious burden resulting from falls in senior citizens. Even when falls do not result in serious injury, fear of falls may be quite compromising. Seniors may be reluctant to report postural instability to their families, caregivers, or clinicians, lest their disclosure result in loss of autonomy, nursing home placement, or other restrictions.
Fortunately, as reported in this systematic review, a substantial number of randomized, controlled trials (n = 283 trials, which included 159,910 participants) provide convincing evidence that interventions are remarkably beneficial. Exercise, correction of impaired vision, supplemental calcium/vitamin D, and environmental interventions reduce falls. The interventions that were multimodal appear to produce additive benefits.
Although these results are encouraging, it is noted that there is some signal for an increase in falls when patients become more mobile subsequent to strength and exercise training. Clinicians are advised to caution patients to be cognizant of the risks of greater levels of activity while enjoying greater mobility.
Financial Disclosure: To reveal any potential bias in this publication, and in accordance with Accreditation Council for Continuing Medical Education guidelines, Dr. Brunton reports he is a retained consultant for Abbott Diabetes, Actavis, AstraZeneca, Becton Dickinson, Boehringer Ingelheim, Cempra, Janssen, Lilly, Merck, Novo Nordisk, Sanofi, and Teva; he serves on the speakers bureau of AstraZeneca, Boehringer Ingelheim, Janssen, Lilly, Novo Nordisk, and Teva. Dr. Kuritzky (author) is a retained consultant for and on the speakers bureau of Allergan, Daiichi Sankyo, Lilly, and Lundbeck. Ms. Coplin, Mr. Springston, and Editorial Group Manager Terrey L. Hatcher report no financial relationships relevant to this field of study.