Update on falls prevention for community-dwelling older adults: review of single and multifactorial intervention programs

The incidence of falls, fall-related injuries, and fall-associated costs continue to rise along with the increase in the aging population. Community-based fall prevention programs for the elderly are proliferating in an attempt to address this health problem. Prevention programs vary widely in their scope, ranging from single intervention strategies to comprehensive multifactorial approaches. Programs have been offered to targeted groups of elderly individuals at high risk for falls and to nonselect groups of community-dwelling elderly adults. This article presents a review of randomized controlled trials that investigated the effectiveness of fall prevention programs for community-dwelling older adults. Following a comprehensive critical analysis of the literature, we present the following guidelines: (1) multifactorial fall prevention programs appear to be more effective for older individuals with a previous fall history versus a nonselect group; (2) medication and vision assessment with appropriate health practitioner referral should be included in a falls screening examination; (3) exercise alone is effective in reducing falls and should include a comprehensive program combining muscle strengthening, balance, and/or endurance training for a minimum of 12 weeks; and (4) home hazard assessment with modifications may be beneficial in reducing falls, especially in a targeted group of individuals.