How to manage falls in community dwelling older adults: a review of the evidence

Recurrent falls in older people are one of the leading causes of hospital admission. There is evidence available for identifying many of those at risk and in whom prevention strategies should be targeted. This review discusses the evidence behind the guidelines and highlights the potential benefits for older people. The key features of prevention include multidisciplinary assessment, by experienced individuals, followed by targeted multifactorial interventions. The impact depends on individual factors such as cognitive impairment and on the setting in which they are used. Screening is feasible but cost implications and benefits are unclear, as are the benefits in terms of injury and fracture prevention. It is known that some of the strongest interventions include individually tailored exercise programmes in cognitively intact individuals. When combined with multifactorial risk reduction programmes this approach can reduce falls risk by approximately 30%.