Prevention of Falls in Community-Dwelling Older Adults:
U.S. Preventive Services Task Force Recommendation Statement
Virginia A. Moyer, MD, MPH, on behalf of the U.S. Preventive Services Task Force*
From the U.S. Preventive Services Task Force, Rockville, Maryland.
Annals of Internal Medicine May 2012
Description: Update of the 1996 U.S. Preventive Services Task Force (USPSTF) recommendation statement on counseling to prevent household and recreational injuries, including falls.
Methods: The USPSTF reviewed new evidence on the effectiveness and harms of primary care–relevant interventions to prevent falls in community-dwelling older adults. The interventions were grouped into 5 main categories: multifactorial clinical assessment (with or without direct intervention), clinical management (with or without screening), clinical education or behavioral counseling, home hazard modification, and exercise or physical therapy.
Recommendations: The USPSTF recommends exercise or physical therapy and vitamin D supplementation to prevent falls in community-dwelling adults aged 65 years or older who are at increased risk for falls. (Grade B recommendation)
The USPSTF does not recommend automatically performing an in-depth multifactorial risk assessment in conjunction with comprehensive management of identified risks to prevent falls in community-dwelling adults aged 65 years or older because the likelihood of benefit is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the balance of benefits and harms on the basis of the circumstances of prior falls, comorbid medical conditions, and patient values. (Grade C recommendation)
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Highlights of the paper from WebMD
- Vitamin D supplementation had a modest impact on fall risk, with analysis of nine studies showing its use to lower this risk by 17% over six to 36 months of follow-up.
- A review of 18 studies found that exercise or physical therapy reduced fall risk by about 13%, which was also considered a modest benefit.
- The task force recommended against routine, in-depth, multiple risk factor assessment and intervention in all people 65 and older,
concluding that decisions about such assessment should be made on a case-by-case basis.
- The data were also insufficient to recommend behavioral counseling or home hazard modification to prevent falls.
PDF is attached at the bottom of this page
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Note: 800 IU is the smallest dose for which they have been able to measure a reduction in falls.
Higher doses produce results in far fewer falls - as well as broken bones.
Fraser Health, in Canada, is giving 20,000 IU weekly
which is an average of 2800 daily, which is 3.5X as much as what the very conservative task force recommended
Overview Falling, Fractures and Vitamin D
It appears that at least 2,000 IU of vitamin D and 500 mg of Calcium are needed to substantially reduce falling
Overview Bone fractures and vitamin D
PREVENTIVE Task force has decided to not PREVENT osteoporosis with vitamin D - 2011
Strange - when there is SO MUCH DATA