Citation

Stubbs B, Brefka S, Denkinger MD. Phys. Ther. 2015; 95(8): 1095-1110.

Affiliation

M.D. Denkinger, MD, Competence Centre of Geriatrics and Aging Research Ulm/Alb-Donau, Ulm, Germany.

Copyright

(Copyright © 2015, American Physical Therapy Association)

DOI

10.2522/ptj.20140461

PMID

25655877

Abstract

BACKGROUND: Preventing falls is an International priority. There is a need to synthesise the highest quality falls prevention evidence in one place for clinicians.

PURPOSE: To conduct an umbrella review of meta-analyses (MA) of randomised controlled trials (RCTs) of falls prevention interventions in community dwelling older adults. DATA SOURCES: MEDLINE, EMBASE, CINAHL, AMED, BNI, PsycINFO, Cochrane Library, PubMed and the PEDro database. STUDY SELECTION: MA with one pooled analysis containing ≥ 3 RCTs investigating any intervention to prevent falls in community dwelling older adults aged ≥ 60 years of age were eligible. 16 MA representing 47 pooled analyses were included. DATA EXTRACTION: Two authors independently extracted data. DATA SYNTHESIS: Data was narratively synthesised. The methodological quality of the MA was moderate. 3 MA defined a fall and 3 reported adverse events (although minor). There is consistent evidence that exercise reduces falls (including the rate, risk and odds of falling) with 13/14 pooled analyses (93%) from 7 MA demonstrating a significant reduction. The methodological quality of meta-analyses investigating exercise were medium/ high and effect sizes ranged from 0.87 (relative risk (RR) 95% CI 0.81-0.94, N=18, n=3568) to 0.39 (rate ratio (RaR) 95% CI 0.23 - 0.66, N=6). There is consistent evidence that multifactorial interventions reduce falls (5/6, 83% reported significant reduction). There is conflicting evidence regarding the influence of vitamin d supplementation (7/12, 58.3% reported significant reduction). LIMITATIONS: MA often used different analysis and reporting of key characteristics was often lacking (e.g. participants, heterogeneity, publication bias). There may be some overlap between included MA.

CONCLUSIONS: There is consistent evidence that exercise and individually tailored multifactorial interventions are effective in reducing falls in the community.

Language: en