US Preventive Services Task Force recommends exercise interventions for seniors at risk for falls

The U.S. Preventive Services Task Force (USPSTF) recommends exercise interventions for preventing falls in community-dwelling older adults at risk for falls and state that recommendations for multifactorial interventions should be individualized. These recommendations form the basis of a final recommendation statement published online June 4 in the Journal of the American Medical Association.

Janelle M. Guirguis-Blake, M.D., from the Kaiser Permanente Research Affiliates Evidence-based Practice Center in Portland, Oregon, and colleagues conducted a systematic review of the evidence on the effectiveness and harms of fall prevention in community-dwelling older adults.

Eighty-three fair- to good-quality randomized clinical trials, with 48,839 participants, examined the effectiveness of six fall prevention interventions, focusing on the two most studied intervention types: multifactorial (28 studies, with 27,784 adults) and exercise (37 studies, with 16,117 adults).

The researchers found that multifactorial interventions were associated with a significant reduction in falls (incidence rate ratio [IRR], 0.84); however, exercise interventions were associated with significant reductions in falls, individual risk for one or more falls, and injurious falls (IRRs, 0.85, 0.92, and 0.84, respectively). Harms associated with these interventions were not well reported and were generally rare.

Based on these findings, the USPSTF recommends exercise interventions for preventing falls in community-dwelling, older adults (age 65 years and older) at increased fall risk (B recommendation). Clinicians should individualize the decision to offer multifactorial interventions for preventing falls among older, community-dwelling adults at increased risk for falls (C recommendation); the overall net benefit for routinely offering multifactorial interventions is small.

"The task force found that health care professionals can help prevent falls in adults 65 and older at increased risk by recommending structured exercise programs," USPSTF member Li Li, M.D., Ph.D., M.P.H., said in a statement.

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