Montero-Odasso, M., et al. "World guidelines for falls prevention and management for older adults." Age and Ageing 2022
The world’s population is aging. Falls and related injuries are increasingly common, making their prevention and management a critical global challenge. Many falls can be prevented. Fall and injury prevention needs multidisciplinary management. Engaging older adults is essential for preventing falls and injuries: understanding their beliefs, attitudes, and priorities about falls and their management is crucial to successfully intervening. Managing many risk factors for falls (e.g., gait and balance problems) has more comprehensive benefits beyond fall prevention, such as improved intrinsic capacities (physical and mental health), functioning, and quality of life. Trained clinicians can estimate the risk of future falls with simple resources. Multidomain interventions (i.e., a combination of interventions tailored to the individual), when delivered, effectively reduce the rate of falls in high-risk community-dwelling older adults. In care homes and hospital settings, all older adults should be considered as high risk, and a standard comprehensive assessment followed by multidomain interventions should be considered. Vitamin D supplementation to prevent falls should be reserved for those at risk of vitamin D deficiency. Modifications to the approaches for assessment and interventions may be needed for older adults with certain medical conditions associated with an increased likelihood of falling.
"It takes a child one year to acquire independent movement and ten years to acquire independent mobility. An old person can lose both in a day"
Professor Bernard Isaacs
The study's conclusion on fall prevention and management in older adults is that a set of evidence- and expert consensus-based recommendations should be implemented for healthcare professionals and other stakeholders. These recommendations should include a person-centered approach, consider the perspectives of older adults, caregivers, and other stakeholders, address gaps in previous guidelines, incorporate recent developments in e-health, and be applicable in locations with limited access to resources. The recommendations emphasize fall prevention and physical activity for all older adults, opportunistic case finding for fall risk, comprehensive multifactorial fall risk assessments for high-risk individuals, and personalized multidomain interventions. The implementation of these recommendations should take into account local context and resources.
Putting the "P" in Fall Prevention:
Predictive:utilization of available information to determine an individual’s risk of falls and fall-related injuries.
Preventative: focused on preventing falls and related injuries while optimizing functional ability.
Personalized:utilizing identified fall risk factors and other relevant clinical information, such as cognition, to develop individualized fall prevention plans.
Participatory: intervention goals and plan developed in collaboration with the older adult and others as they wish to consider priorities, values, and resources, such as care support.
Sparta Science Insight:
The global population is undergoing a significant aging trend, resulting in a rising incidence of falls and related injuries. Consequently, preventing and managing these incidents has become a pressing global concern. Opportunistic case-finding becomes imperative, as older adults may not seek medical attention following a fall and might be hesitant to report such incidents. Effective strategies involve tailored multidomain interventions that address individual risk factors. Furthermore, it is crucial to engage with older individuals to understand their beliefs, attitudes, and priorities concerning falls and their management. It's worth noting that some of these recommendations may require adjustments to suit low-resource settings and specific country needs.