Key messages
Simple household measures such as attaching handrails, non-slip strips to the carpets or tidying up reduce the risk of falls in the elderly by 26%. In the group of people with a high risk of falling, these effects are even more pronounced with a risk reduction of 38%. This is the result of a Cochrane analysis of more than 20 international studies.
Background
From the age of 65, it is estimated that every person falls at least once in 12 months.The consequences of a fall are often serious in old age, the risk of bone fractures and other injuries increases significantly, including fatal complications. Most falls occur at home. In a systematic review, a team of scientists from the Cochrane Institute investigated which measures are most effective at reducing the risk of falls in elderly people living at home ( https://doi.org/10.1002/14651858.CD013258.pub2; [1]).
Design
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Study method: Systematic search of scientific databases for controlled randomised trials investigating the effects of environmental changes on the risk of falls in older people (≥ 60 years)
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Primary endpoint: Fall rate
Study method: Systematic search of scientific databases for controlled randomised trials investigating the effects of environmental changes on the risk of falls in older people (≥ 60 years)
Primary endpoint: Fall rate
Main results
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22 studies with data from 8,463 elderly people from 10 countries were included, the participants (65%) and participants were on average 78 years old.
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The reduction of hazards in the home environment reduced the probability of falls by 26%, from 1319 falls/1 000 persons/year to 976 falls/1 000 persons per year (Rate Ratio [RaR]: 0,74; 95% confidence interval: 0.61-0.91).
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The preventive measures mainly consisted of an assessment of danger points in the household combined with a reduction of the risk, for example by tidying up, installing handrails and non-slip strips on the carpets.
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These interventions were 38% more effective in people who had a higher risk of falling under known criteria than in lower-risk participants.
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Based on the analysis, the study team calculated that among 1,000 people who followed these measures for one year, the total number of falls would decrease from 1,847 to 1,145.The importance of educational discussions on fall prevention could not be clarified in this analysis for methodological reasons.
22 studies with data from 8,463 elderly people from 10 countries were included, the participants (65%) and participants were on average 78 years old.
The reduction of hazards in the home environment reduced the probability of falls by 26%, from 1319 falls/1 000 persons/year to 976 falls/1 000 persons per year (Rate Ratio [RaR]: 0,74; 95% confidence interval: 0.61-0.91).
The preventive measures mainly consisted of an assessment of danger points in the household combined with a reduction of the risk, for example by tidying up, installing handrails and non-slip strips on the carpets.
These interventions were 38% more effective in people who had a higher risk of falling under known criteria than in lower-risk participants.
Based on the analysis, the study team calculated that among 1,000 people who followed these measures for one year, the total number of falls would decrease from 1,847 to 1,145.The importance of educational discussions on fall prevention could not be clarified in this analysis for methodological reasons.
Clinical significance
«Measures to reduce the risk of falling in the home environment require professional assessment and implementation, not just a short checklist,» explained Lindy Clemson, Professor Emeritus at the University of Sydney and lead author of the study (2). «Admittedly, those affected and their relatives can and should also pay attention to the home environment themselves. Exercises for balance and strength of the legs are also useful. Nevertheless, professional support from an occupational therapist is an important measure for people at risk of falling,» says Clemson.
With regard to other investigated approaches to fall prevention such as education, checking glasses or special shoes, the review found little evidence for a reduction in the probability of falling, according to Clemson.More research is needed in this area.
Funding: according to Cochrane’s statutes
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Source — https://www.univadis.de/viewarticle/cochrane-analyse-sturzrisiko-%25C3%25A4lterer-menschen-mit-2023a100056w