Cochrane Summaries

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Interventions for preventing falls in older people in care facilities and hospitals

Cameron ID, Gillespie LD, Robertson MC, Murray GR, Hill KD, Cumming RG, Kerse N
Published Online: 
28 March 2013

Falls by older people in residential or nursing care facilities and hospitals are common events that may cause loss of independence, injuries, and sometimes death as a result of injury. Effective interventions to prevent falls are important as they will have significant health benefits.

This review included 60 randomised controlled trials involving 60,345 participants. Forty-three trials (30,373 participants) were in care facilities, and 17 (29,972 participants) in hospitals. Despite the large number of trials, there was limited evidence to support any one intervention.

In care facilities, the prescription of vitamin D reduced the number of falls, probably because residents have low vitamin D levels. Results from 13 trials testing exercise interventions in care facilities were inconsistent and overall did not show a benefit. It may be that exercise programmes increase falls in frail residents and reduce falls in less frail residents. Interventions targeting multiple risk factors may be effective in reducing the number of falls.

Additional physiotherapy reduced the number of people falling in hospital rehabilitation wards and interventions targeting multiple risk factors reduced falls in hospital.