Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement

Authors

Wanda K. Nicholson, George Washington University, Washington, DC.
Michael Silverstein, Brown University, Providence, Rhode Island.
John B. Wong, Tufts University School of Medicine, Boston, Massachusetts.
Michael J. Barry, Harvard Medical School, Boston, Massachusetts.
David Chelmow, Virginia Commonwealth University, Richmond.
Tumaini Rucker Coker, University of Washington, Seattle.
Esa M. Davis, University of Maryland School of Medicine, Baltimore.
Carlos Roberto Jaén, The University of Texas Health Science Center, San Antonio.
Marie Krousel-Wood, Tulane University, New Orleans, Louisiana.
Sei Lee, University of California, San Francisco.
Li Li, University of Virginia, Charlottesville.
Goutham Rao, Case Western Reserve University, Cleveland, Ohio.
John M. Ruiz, University of Arizona, Tucson.
James Stevermer, University of Missouri, Columbia.
Joel Tsevat, The University of Texas Health Science Center, San Antonio.
Sandra Millon Underwood, University of Wisconsin, Milwaukee.
Sarah Wiehe, Indiana University, Bloomington.

Document Type

Journal Article

Publication Date

7-2-2024

Journal

JAMA

Volume

332

Issue

1

DOI

10.1001/jama.2024.8481

Abstract

IMPORTANCE: Falls are the leading cause of injury-related morbidity and mortality among older adults in the US. In 2018, 27.5% of community-dwelling adults 65 years or older reported at least 1 fall in the past year and 10.2% reported a fall-related injury. In 2021, an estimated 38 742 deaths resulted from fall-related injuries. OBJECTIVE: The US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate the effectiveness and harms of primary care-relevant interventions to prevent falls and fall-related morbidity and mortality in community-dwelling adults 65 years or older. POPULATION: Community-dwelling adults 65 years or older at increased risk of falls. EVIDENCE ASSESSMENT: The USPSTF concludes with moderate certainty that exercise interventions provide a moderate net benefit in preventing falls and fall-related morbidity in older adults at increased risk for falls. The USPSTF concludes with moderate certainty that multifactorial interventions provide a small net benefit in preventing falls and fall-related morbidity in older adults at increased risk for falls. RECOMMENDATION: The USPSTF recommends exercise interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. (B recommendation) The USPSTF recommends that clinicians individualize the decision to offer multifactorial interventions to prevent falls to community-dwelling adults 65 years or older who are at increased risk for falls. Existing evidence indicates that the overall net benefit of routinely offering multifactorial interventions to prevent falls is small. When determining whether this service is appropriate for an individual, patients and clinicians should consider the balance of benefits and harms based on the circumstances of prior falls, presence of comorbid medical conditions, and the patient's values and preferences. (C recommendation).

APA Citation

Nicholson, Wanda K.; Silverstein, Michael; Wong, John B.; Barry, Michael J.; Chelmow, David; Coker, Tumaini Rucker; Davis, Esa M.; Jaén, Carlos Roberto; Krousel-Wood, Marie; Lee, Sei; Li, Li; Rao, Goutham; Ruiz, John M.; Stevermer, James; Tsevat, Joel; Underwood, Sandra Millon; and Wiehe, Sarah, "Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement" (2024). GW Authored Works. Paper 5337.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5337

Department

Prevention and Community Health