Structured Abstract

Contents

• 1. Introduction
  • Scope and Purpose
  • Condition Definition
  • Prevalence and Burden of Disease/Illness
  • Etiology and Risk Factors
  • Rationale and Current Practice
  • Previous USPSTF Recommendation
• 2. Methods
  • Key Questions and Analytic Framework
  • Search Strategy and Selection Criteria
  • Article Review and Data Abstraction
  • Literature Synthesis
  • USPSTF Involvement
• 3. Results
  • KQ 1 Is There Direct Evidence That Primary Care Interventions Reduce Fall-Related Injury, Improve Quality of Life, Reduce Disability, or Reduce Mortality When Used Alone or in Combination to Reduce Falls in Community-Dwelling Older Adults?
  • KQ 2 Do Primary Care Interventions Used Alone or in Combination in Community-Dwelling Older Adults Reduce Risk for or Rate of Falls/Fallers?
  • KQ 1a Do These Interventions Reduce Injury, Improve Quality of Life, Reduce Disability, or Reduce Mortality in Older Adults Specifically Identified as High Risk for Falls?
  • KQ 2a Do These Interventions Reduce Falls in Older Adults Specifically Identified as High Risk for Falls?
  • KQ 2b Are There Positive Outcomes Other Than Reduced Falls and Related Morbidity and Mortality That Result From Primary Care Falls Interventions?
  • KQ 3 What Are the Adverse Effects Associated With Interventions to Reduce Falls?
  • KQ 4 How Are Community-Dwelling Older Adults Identified for Primary Care Interventions to Prevent Falls?
• 4. Discussion
  • Summary of Review Findings
  • Multifactorial Assessment and Management
  • Single Clinical Treatment
  • Clinical Education/Behavioral Counseling
  • Physical Activity
  • Home Hazard Modification
  • Comparison With Other Reviews of Interventions to Prevent Falls
  • Harms
  • Contextual Issues
  • Limitations
  • Emerging Issues/Next Steps
  • Future Research
  • Conclusions
• References
• Appendixes
  • Appendix A Terminology and Abbreviations
  • Appendix B Search
  • Appendix C Evidence Tables (KQs 1, 2, 4)
  • Appendix D Evidence Tables (KQ3)
  • Appendix E Role of Falls History in Identifying High-Risk Adults
  • Appendix F Meta-Analysis
  • Appendix G Trials
  • Appendix H Risk Categories and Other Outcome Measures

The final version of this updated systematic review was submitted to the Agency for Healthcare Research and Quality in July 2009. A manuscript derived from this report was published in Annals of Internal Medicine on December 21, 2010 (Michael YL, Whitlock EP, Lin JS, et al. Primary care relevant interventions to prevent falling in older adults: a systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med. 2010;153:815–824). This manuscript contains additional data published through February 2010, which was not available at the time this evidence report was finalized. Please refer to the manuscript for updated information.

Consultant: Elizabeth Eckstrom, MD, MPH

Prepared for: Agency for Health Care Research and Quality, U.S. Department of Health and Human Services.¹ Contract Number: HHSA-290-2007-10057-I, Task Order Number 3. Prepared by: Oregon Evidence-based Practice Center Center for Health Research, Kaiser Permanente Northwest.²

Suggested citation:

Michael YL, Lin JS, Whitlock EP, Gold R, Fu R, O’Connor EA, Zuber SP, Beil TL, Lutz KW. Interventions to Prevent Falls in Older Adults: An Updated Systematic Review. Evidence Synthesis No. 80. AHRQ Publication No. 11-05150-EF-1. Rockville, MD: Agency for Healthcare Research and Quality; December 2010.

This report is based on research conducted by the Oregon Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. HHSA-290-2007-10057-I). The investigators involved have declared no conflicts of interest with objectively conducting this research. The findings and conclusions in this document are those of the authors, who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment.

This report may be used, in whole or in part, as the basis for the development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

1

540 Gaither Road, Rockville, MD 20850; www​.ahrq.gov

2

3800 North Interstate Avenue, Portland, OR 97227