Abstract
Objective
To determine whether single interventions (SI), multifactorial interventions (MI),
or multiple component interventions (MCI) including vitamin D supplementation prevent
the incidence of falls and fall risk factors among older adults who are community-dwelling
or living in long-term care facilities.
Design
Systematic review.
Methods
PubMed, Scopus, MEDLINE, and Cochrane were searched with restrictions applied to publication
year (2015‒2019) and language (limited to studies published in English). After duplicate
removal and title and abstract screening, 2 authors independently identified eligible
studies on the basis of inclusion criteria. Risk of bias and quality of evidence were
assessed.
Results
Thirty-four studies were included after screening titles and abstracts from 855 citations
and 129 full-text articles. Thirteen randomized-controlled trials and clinical trials
(5 on MI, 1 on MCI, and 7 on SI) including 2232 participants and 21 systematic reviews
(assessing SI, MI, MCI, or all) were extracted for qualitative synthesis. Fifteen
out of 20 studies that reported outcomes on falls rate found a significant reduction.
Seventeen out of 23 studies with outcomes on fall risk factors concluded a significant
improvement. Five studies found no significant differences in falls incidence, and
5 studies found no significant differences in fall risks. One study reported worsened
outcomes, including poorer balance.
Conclusion and Implications
Although results are inconclusive, SI, MI, and MCI involving exercises may prevent
falls. Vitamin D supplementation may be beneficial alongside exercise; however, whether
vitamin D use consistently reduces falls incidence or fall risks remains uncertain.
Exercises that are individually tailored to participants’ capabilities and risks may
be the most effective falls prevention interventions. Implementation may reduce medical
costs and improve quality of life for older adults who are community-dwelling or are
living in long-term care facilities.
Keywords
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Article info
Publication history
Published online: July 06, 2020
Footnotes
This research did not receive any funding from agencies in the public, commercial, or not-for-profit sectors.
The authors declare no conflicts of interest.
Identification
Copyright
Crown Copyright © 2020 Published by Elsevier Inc. on behalf of AMDA - The Society for Post-Acute and Long-Term Care Medicine.
