Falls in the elderly. II. Strategies for prevention.

In the companion paper, we have outlined how relevant risk factors for falls can be identified using a systematic approach. Once identified, the underlying diseases and pattern of (usually multiple) risk factors guides the design of an individually tailored intervention program. Such intervention programs follow one or more of the following goals: (a) to treat the underlying disease; (b) to reduce or even eliminate the number of falls; (c) to prevent or minimise the associated injuries; and (d) tertiary prevention of fall-related disability, including immobilisation, muscle weakness, reduced fitness, osteoporosis, fear of falling and mortality. The successful results of various intervention studies underscores that falls should be regarded as a potentially treatable disorder in elderly persons. Such knowledge is important for clinicians, which could apply prevention strategies to individual patients with risk factors that are strongly associated with falls. In addition, prevention is important for health policy makers who aim to reduce falls in the general population by reducing or eliminating commonly present risk factors (even if they are only weakly associated with falls)

Falls in the elderly. II. Strategies for prevention.

Item does not contain fulltextIn the companion paper, we have outlined how relevant risk factors for falls can be identified using a systematic approach. Once identified, the underlying diseases and pattern of (usually multiple) risk factors guides the design of an individually tailored intervention program. Such intervention programs follow one or more of the following goals: (a) to treat the underlying disease; (b) to reduce or even eliminate the number of falls; (c) to prevent or minimise the associated injuries; and (d) tertiary prevention of fall-related disability, including immobilisation, muscle weakness, reduced fitness, osteoporosis, fear of falling and mortality. The successful results of various intervention studies underscores that falls should be regarded as a potentially treatable disorder in elderly persons. Such knowledge is important for clinicians, which could apply prevention strategies to individual patients with risk factors that are strongly associated with falls. In addition, prevention is important for health policy makers who aim to reduce falls in the general population by reducing or eliminating commonly present risk factors (even if they are only weakly associated with falls)

A multidisciplinary fall prevention program for elderly persons: A feasibitity study

Failing is a common problem among elderly people and has many negative consequences. In the Netherlands, there is a need for effective fall prevention interventions aimed at elderly persons with an increased risk of falling. For this reason, we adapted a successful British fall prevention program comprising a medical occupational therapy assessment to the Dutch health care setting. This article describes the adaptation of this program and a pilot study to assess its feasibility in Dutch health care according to the implementers of the intervention as well as the participants (n = 21). This study showed that the Dutch intervention protocol is feasible in Dutch health care for both participants and implementers of the program. However, minor refinement of the intervention is warranted to improve its feasibility. The structured approach to adapt and pretest an intervention protocol appeared to be essential when aiming to implement a complex intervention program in a different health care setting

Predictive validity and cut-off scores in four diagnostic tests for falls – a study in frail older people at home

Artikkelen rapporterer en studie hvor hensikten var å undersøke validiteten og treffsikkerheten for instrumentene Downton Fall Risk Index, Timed Up and Go og Romberg test, når det gjelder prediksjon av fall hos hjemmeboende eldre.No study has investigated the predictive validity and cut-off scores in diagnostic tests for falls used in in-home assessment in frail older people. The objective was to investigate the predictive validity for falls in the Downton Fall Risk Index (DFRI), Timed Up and Go (TUG) and Romberg test (RT) used in in-home assessment of frail older people (65+ years). Data on the diagnostic tests were collected at baseline (N = 153) and fall frequency were collected at six- and twelve-month follow-ups. The optimal cut-offs were 3 p in DFRI and 12 s in TUG. However, the validity indexes were generally low and only 40–50% were correctly classified. The RT showed low sensitivity. To increase the predictive validity for falls in this context, the use of DFRI and/or TUG as a part of a comprehensive fall-risk assessment tool, should be investigated in future studies