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Prevention of Falls in Community-Dwelling Older Adults
Clinical Summary of U.S. Preventive Services Task Force Recommendation
|Population||Community-dwelling adults aged 65 years and older who are at increased risk for falls||Community-dwelling adults aged 65 years and older|
|Recommendation||Provide intervention consisting of exercise or physical therapy and/or vitamin D supplementation to prevent falls.
|Do not automatically perform an in-depth multifactorial risk assessment with comprehensive management of identified risks to prevent falls.
|Risk Assessment||Primary care clinicians can consider the following factors to identify older adults at increased risk for falls: a history of falls, a history of mobility problems, and poor performance on the timed Get-Up-and-Go test.|
|Interventions||Effective exercise and physical therapy interventions include group classes and at-home physiotherapy strategies and range in intensity from very low (≤9 hours) to high (>75 hours).
Benefit from vitamin D supplementation occurs by 12 months; the efficacy of treatment of shorter duration is unknown. The recommended daily allowance for vitamin D is 600 IU for adults aged 51 to 70 years and 800 IU for adults older than 70 years.
Comprehensive multifactorial assessment and management interventions include assessment of multiple risk factors for falls and providing medical and social care to address factors identified during the assessment. 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, medical comorbid conditions, and patient values.
|Balance of Harms and Benefits||Exercise or physical therapy and vitamin D supplementation have a moderate benefit in preventing falls in older adults.||Multifactorial risk assessment with comprehensive management of identified risks has at least a small benefit in preventing falls in older adults.|
|Other Relevant USPSTF Recommendations||Recommendations on screening for other types of cancer can be found at http://www.uspreventiveservicestaskforce.org.|
For a summary of the evidence systematically reviewed in making these recommendations, the full recommendation statement, and supporting documents, please go to http://www.uspreventiveservicestaskforce.org.
Disclaimer: Recommendations made by the USPSTF are independent of the U.S. government. They should not be construed as an official position of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
AHRQ Publication No. 11-05150-EF-3
Current as of May 2012
U.S. Preventive Services Task Force. Prevention of Falls in Community-Dwelling Older Adults: Clinical Summary of U.S. Preventive Services Task Force Recommendation. AHRQ Publication No. 11-05150-EF-3. May 2012. http://www.uspreventiveservicestaskforce.org/uspstf11/fallsprevention/fallsprevsum.htm