Clinical Summary
Falls Prevention in Community-Dwelling Older Adults: Interventions
April 17, 2018
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.
| Population | Community-dwelling adults 65 years or older at increased risk for falls, without osteoporosis or vitamin D deficiency | ||
|---|---|---|---|
| Recommendation | Recommend exercise interventions to prevent falls. Grade: B
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Selectively offer multifactorial interventions to prevent falls. Grade: C |
Do not recommend vitamin D supplementation to prevent falls. Grade: D |
| Risk Assessment | Age is strongly related to risk for falls. A pragmatic approach to identifying older persons at high risk for falls would be to assess for a history of falls or physical function/mobility limitation problems. Clinicians could also use assessments of gait and mobility, such as the Timed Up and Go test. | ||
| Interventions | Effective exercise interventions include supervised individual and group classes and physical therapy. Given the heterogeneity of these interventions, it is difficult to identify specific components of exercise that are particularly efficacious.
Multifactorial interventions include an initial assessment of modifiable risk factors for falls and subsequent customized interventions for each patient based on issues identified in the initial assessment. The initial assessment could include a multidisciplinary comprehensive geriatric assessment or an assessment using a combination of various components, such as balance, gait, vision, postural blood pressure, medication, environment, cognition, and psychological health. |
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| Other Relevant USPSTF Recommendations | The USPSTF found insufficient evidence on vitamin D or calcium supplementation to prevent fractures in men, premenopausal women at any dose, and in postmenopausal women at doses >400 IU of vitamin D and >1000 mg of calcium. The USPSTF recommends against supplementation with ≤400 IU of vitamin D or ≤1000 mg of calcium in postmenopausal women. The USPSTF recommends screening for osteoporosis in women 65 years or older and in younger women at increased risk. | ||
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.