Secondary Prevention of Falls in Older People

Review Article

Secondary Prevention of Falls in Older People: A Systematic Review

Chin-Ying Chen 1, Arminee Kazanjian 2, Martha Donnelly 3

Although several systematic reviews have been reported on fall prevention for older people, there is no review on secondary prevention of falls for older people. Our objective is to assess the effectiveness of intervention programs on secondary prevention of falls in older people. The study design is a systematic review of published controlled clinical designed studies for older people with a history of falls. We used keyword searches of MEDLINE, CINAHL, and EMBASE from 1996 to March 2002. Only English literatures were reviewed. Studies were reviewed if they met the following criteria: (1) randomized controlled trials (RCT); (2) participants were aged 65 years or older; (3) participants had history of falls; (4) secondary prevention of falls was an aim of the study. A total of 5 RCT met the criteria. Two multifactorial targeted intervention programs showed significant reduction of the risk of falling and /or recurrent falling. One multifactorial targeted intervention program revealed the tendency of reduction for subjects with recent recurrent falls ( exercise program as a single intervention was not effective. There is no evidence of exercise as a single intervention for secondary prevention of falls in older people. Occupational therapy home assessment is effective in the subgroup with history of falls, but further study is indicated for the widespread implementation as an individual fall prevention strategy. Several well-designed studies have shown the effectiveness of multifactorial targeted intervention. The tendency of effectiveness by multifactorial targeted intervention in subjects with recent recurrent falls need further study. (Tw Fam Med Res 2005; 3: 49-64) Key words: accidental falls, aged, review literature 2 falls). One occupational therapy intervention was effective in the subgroup with history of falls,...