Falls by older people in nursing care facilities and hospitals are common events that may cause loss of independence, injuries, and sometimes death as a result of injury.
Effective interventions are important as they will have significant health benefits.
This review includes 41 trials involving 25,422 participants, with about three quarters being women and having an average age of 83 years. Many of the participants had cognitive problems.
In nursing care facilities, interventions targeting multiple risk factors were not clearly effective in preventing falls but may be so when these interventions are provided by a co-ordinated team of health workers. The prescription of vitamin D reduces falls, as may a review of medication by a pharmacist.
There is no evidence that other interventions targeting single risk factors reduce falls and this includes exercise interventions.
For patients who are in hospital for more than a few weeks, interventions targeting multiple risk factors, and supervised exercise, are effective.
Limitations of the review included the small number of hospital studies, difficulty isolating effects of individual components of treatments that involved multiple components, and the variability of interventions.
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