New horizons in falls prevention and management for older adults: a global initiative

doi:10.1093/ageing/afab076

. 2021 Sep 11;50(5):1499-1507.

doi: 10.1093/ageing/afab076.

New horizons in falls prevention and management for older adults: a global initiative

Manuel Montero-Odasso^{1

2

3}, Nathalie van der Velde⁴, Neil B Alexander⁵, Clemens Becker⁶, Hubert Blain⁷, Richard Camicioli⁸, Jacqueline Close^{9

10}, Leilei Duan¹¹, Gustavo Duque¹², David A Ganz¹³, Fernando Gómez¹⁴, Jeffrey M Hausdorff^{15

16

17}, David B Hogan¹⁸, Jose R Jauregui¹⁹, Rose Anne Kenny²⁰, Lewis A Lipsitz²¹, Pip A Logan²², Stephen R Lord^{23

24}, Louise Mallet²⁵, David R Marsh²⁶, Finbarr C Martin²⁷, Koen Milisen^{28

29}, Alice Nieuwboer³⁰, Mirko Petrovic³¹, Jesper Ryg³², Ervin Sejdic³³, Cathie Sherrington³⁴, Dawn A Skelton³⁵, Mark Speechley^{3

36}, Maw Pin Tan^{37

38}, Chris Todd^{39

40}, Tischa van der Cammen⁴¹, Joe Verghese^{42

43}, Nellie Kamkar¹, Yanina Sarquis-Adamson¹, Tahir Masud^{32

44}; Task Force on Global Guidelines for Falls in Older Adults

Affiliations

¹ Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada.
² Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada.
³ Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada.
⁴ Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
⁵ Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan; Veterans Administration Ann Arbor Healthcare System Geriatrics Research Education Clinical Center, Ann Arbor, Michigan, USA.
⁶ Unit Digital Geriatric Medicine, Medical Faculty of the University of Heidelberg, Germany.
⁷ Department of Geriatrics, Montpellier University Hospital and MUSE, Montpellier, France.
⁸ Department of Medicine (Neurology) and Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada.
⁹ Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, Australia.
¹⁰ Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.
¹¹ National Centre for Chronic and Noncommunicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China.
¹² Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Melbourne, Victoria, Australia.
¹³ Multicampus Program in Geriatric Medicine and Gerontology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
¹⁴ Research Group on Geriatrics and Gerontology, International Association of Gerontology and Geriatrics Collaborative Center, University de Caldas, Manizales, Colombia.
¹⁵ Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
¹⁶ Department of Physical Therapy, Sackler Faculty of Medicine, and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
¹⁷ Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
¹⁸ Division of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
¹⁹ Ageing Biology Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
²⁰ Department of Medical Gerontology, Mercers Institute for Ageing, St James Hospital, Dublin 8, Ireland.
²¹ Hinda and Arthus Marcus Institute for Aging Research, Hebrew SeniorLife, and Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA, USA.
²² School of Medicine, University of Nottingham, Nottingham, UK.
²³ Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia.
²⁴ School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia.
²⁵ Faculty of Pharmacy, Université de Montréal, and Department of Pharmacy, McGill University Health Center, Montreal, QC, Canada.
²⁶ University College London, London UK.
²⁷ Population Health Sciences, Faculty of Life Sciences and Medicine, King's College, London, UK.
²⁸ Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.
²⁹ Department of Geriatric Medicine, University Hospitals, Leuven, Belgium.
³⁰ Department of Rehabilitation Sciences, Neurorehabilitation Research Group (eNRGy), KU Leuven, Leuven, Belgium.
³¹ Department of Internal Medicine and Paediatrics, Section of Geriatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
³² Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark; Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
³³ Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
³⁴ Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.
³⁵ School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
³⁶ Schulich Interfaculty Program in Public Health, Schulich School of Medicine & Dentistry, University of Western Ontario London, ON, Canada.
³⁷ Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.
³⁸ Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
³⁹ School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
⁴⁰ Manchester University NHS Foundation Trust, Manchester, UK.
⁴¹ Department of Human-Centered Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands.
⁴² Division of Geriatrics, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
⁴³ Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.
⁴⁴ Department of Geriatric Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK.

PMID: 34038522
DOI: 10.1093/ageing/afab076

New horizons in falls prevention and management for older adults: a global initiative

Manuel Montero-Odasso et al. Age Ageing. 2021.

. 2021 Sep 11;50(5):1499-1507.

doi: 10.1093/ageing/afab076.

Authors

Affiliations

¹ Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada.
² Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada.
³ Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada.
⁴ Department of Internal Medicine, Section of Geriatric Medicine, Amsterdam Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
⁵ Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan; Veterans Administration Ann Arbor Healthcare System Geriatrics Research Education Clinical Center, Ann Arbor, Michigan, USA.
⁶ Unit Digital Geriatric Medicine, Medical Faculty of the University of Heidelberg, Germany.
⁷ Department of Geriatrics, Montpellier University Hospital and MUSE, Montpellier, France.
⁸ Department of Medicine (Neurology) and Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada.
⁹ Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, Australia.
¹⁰ Prince of Wales Clinical School, University of New South Wales, Sydney, Australia.
¹¹ National Centre for Chronic and Noncommunicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China.
¹² Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Melbourne, Victoria, Australia.
¹³ Multicampus Program in Geriatric Medicine and Gerontology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
¹⁴ Research Group on Geriatrics and Gerontology, International Association of Gerontology and Geriatrics Collaborative Center, University de Caldas, Manizales, Colombia.
¹⁵ Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
¹⁶ Department of Physical Therapy, Sackler Faculty of Medicine, and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
¹⁷ Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA.
¹⁸ Division of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
¹⁹ Ageing Biology Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
²⁰ Department of Medical Gerontology, Mercers Institute for Ageing, St James Hospital, Dublin 8, Ireland.
²¹ Hinda and Arthus Marcus Institute for Aging Research, Hebrew SeniorLife, and Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA, USA.
²² School of Medicine, University of Nottingham, Nottingham, UK.
²³ Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia.
²⁴ School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia.
²⁵ Faculty of Pharmacy, Université de Montréal, and Department of Pharmacy, McGill University Health Center, Montreal, QC, Canada.
²⁶ University College London, London UK.
²⁷ Population Health Sciences, Faculty of Life Sciences and Medicine, King's College, London, UK.
²⁸ Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.
²⁹ Department of Geriatric Medicine, University Hospitals, Leuven, Belgium.
³⁰ Department of Rehabilitation Sciences, Neurorehabilitation Research Group (eNRGy), KU Leuven, Leuven, Belgium.
³¹ Department of Internal Medicine and Paediatrics, Section of Geriatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
³² Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark; Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
³³ Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
³⁴ Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.
³⁵ School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
³⁶ Schulich Interfaculty Program in Public Health, Schulich School of Medicine & Dentistry, University of Western Ontario London, ON, Canada.
³⁷ Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia.
³⁸ Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
³⁹ School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.
⁴⁰ Manchester University NHS Foundation Trust, Manchester, UK.
⁴¹ Department of Human-Centered Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands.
⁴² Division of Geriatrics, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
⁴³ Department of Neurology, Albert Einstein College of Medicine, Bronx, New York, USA.
⁴⁴ Department of Geriatric Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK.

PMID: 34038522
DOI: 10.1093/ageing/afab076

Abstract

Background: falls and fall-related injuries are common in older adults, have negative effects both on quality of life and functional independence and are associated with increased morbidity, mortality and health care costs. Current clinical approaches and advice from falls guidelines vary substantially between countries and settings, warranting a standardised approach. At the first World Congress on Falls and Postural Instability in Kuala Lumpur, Malaysia, in December 2019, a worldwide task force of experts in falls in older adults, committed to achieving a global consensus on updating clinical practice guidelines for falls prevention and management by incorporating current and emerging evidence in falls research. Moreover, the importance of taking a person-centred approach and including perspectives from patients, caregivers and other stakeholders was recognised as important components of this endeavour. Finally, the need to specifically include recent developments in e-health was acknowledged, as well as the importance of addressing differences between settings and including developing countries.

Methods: a steering committee was assembled and 10 working Groups were created to provide preliminary evidence-based recommendations. A cross-cutting theme on patient's perspective was also created. In addition, a worldwide multidisciplinary group of experts and stakeholders, to review the proposed recommendations and to participate in a Delphi process to achieve consensus for the final recommendations, was brought together.

Conclusion: in this New Horizons article, the global challenges in falls prevention are depicted, the goals of the worldwide task force are summarised and the conceptual framework for development of a global falls prevention and management guideline is presented.

Keywords: aged; clinical practice; consensus; falls; guidelines; injury; older adults; world.

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New horizons in falls prevention and management for older adults: a global initiative

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New horizons in falls prevention and management for older adults: a global initiative

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