Environmental interventions for preventing falls in older people living in the community
- PMID: 36893804
- PMCID: PMC9998238
- DOI: 10.1002/14651858.CD013258.pub2
Environmental interventions for preventing falls in older people living in the community
Abstract
Background: Falls and fall-related injuries are common. A third of community-dwelling people aged over 65 years fall each year. Falls can have serious consequences including restricting activity or institutionalisation. This review updates the previous evidence for environmental interventions in fall prevention.
Objectives: To assess the effects (benefits and harms) of environmental interventions (such as fall-hazard reduction, assistive technology, home modifications, and education) for preventing falls in older people living in the community.
Search methods: We searched CENTRAL, MEDLINE, Embase, other databases, trial registers, and reference lists of systematic reviews to January 2021. We contacted researchers in the field to identify additional studies.
Selection criteria: We included randomised controlled trials evaluating the effects of environmental interventions (such as reduction of fall hazards in the home, assistive devices) on falls in community-residing people aged 60 years and over. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. Our primary outcome was rate of falls.
Main results: We included 22 studies from 10 countries involving 8463 community-residing older people. Participants were on average 78 years old, and 65% were women. For fall outcomes, five studies had high risk of bias and most studies had unclear risk of bias for one or more risk of bias domains. For other outcomes (e.g. fractures), most studies were at high risk of detection bias. We downgraded the certainty of the evidence for high risk of bias, imprecision, and/or inconsistency. Home fall-hazard reduction (14 studies, 5830 participants) These interventions aim to reduce falls by assessing fall hazards and making environmental safety adaptations (e.g. non-slip strips on steps) or behavioural strategies (e.g. avoiding clutter). Home fall-hazard interventions probably reduce the overall rate of falls by 26% (rate ratio (RaR) 0.74, 95% confidence interval (CI) 0.61 to 0.91; 12 studies, 5293 participants; moderate-certainty evidence); based on a control group risk of 1319 falls per 1000 people a year, this is 343 (95% CI 118 to 514) fewer falls. However, these interventions were more effective in people who are selected for higher risk of falling, with a reduction of 38% (RaR 0.62, 95% CI 0.56 to 0.70; 9 studies, 1513 participants; 702 (95% CI 554 to 812) fewer falls based on a control risk of 1847 falls per 1000 people; high-certainty evidence). We found no evidence of a reduction in rate of falls when people were not selected for fall risk (RaR 1.05, 95% CI 0.96 to 1.16; 6 studies, 3780 participants; high-certainty evidence). Findings were similar for the number of people experiencing one or more falls. These interventions probably reduce the overall risk by 11% (risk ratio (RR) 0.89, 95% CI 0.82 to 0.97; 12 studies, 5253 participants; moderate-certainty evidence); based on a risk of 519 per 1000 people per year, this is 57 (95% CI 15 to 93) fewer fallers. However, for people at higher risk of falling, we found a 26% decrease in risk (RR 0.74, 95% CI 0.65 to 0.85; 9 studies, 1473 participants), but no decrease for unselected populations (RR 0.99, 95% CI 0.92 to 1.07; 6 studies, 3780 participants) (high-certainty evidence). These interventions probably make little or no important difference to health-related quality of life (HRQoL) (standardised mean difference 0.09, 95% CI -0.10 to 0.27; 5 studies, 1848 participants; moderate-certainty evidence). They may make little or no difference to the risk of fall-related fractures (RR 1.00, 95% 0.98 to 1.02; 2 studies, 1668 participants), fall-related hospitalisations (RR 0.96, 95% CI 0.87 to 1.06; 3 studies, 325 participants), or in the rate of falls requiring medical attention (RaR 0.91, 95% CI 0.58 to 1.43; 3 studies, 946 participants) (low-certainty evidence). The evidence for number of fallers requiring medical attention was unclear (2 studies, 216 participants; very low-certainty evidence). Two studies reported no adverse events. Assistive technology Vision improvement interventions may make little or no difference to the rate of falls (RaR 1.12, 95% CI 0.84 to 1.50; 3 studies, 1489 participants) or people experiencing one or more falls (RR 1.09, 95% CI 0.79 to 1.50) (low-certainty evidence). We are unsure of the evidence for fall-related fractures (2 studies, 976 participants) and falls requiring medical attention (1 study, 276 participants) because the certainty of the evidence is very low. There may be little or no difference in HRQoL (mean difference 0.40, 95% CI -1.12 to 1.92) or adverse events (falls while switching glasses; RR 1.00, 95% CI 0.98 to 1.02) (1 study, 597 participants; low-certainty evidence). Results for other assistive technology - footwear and foot devices, and self-care and assistive devices (5 studies, 651 participants) - were not pooled due to the diversity of interventions and contexts. Education We are uncertain whether an education intervention to reduce home fall hazards reduces the rate of falls or the number of people experiencing one or more falls (1 study; very low-certainty evidence). These interventions may make little or no difference to the risk of fall-related fractures (RR 1.02, 95% CI 0.96 to 1.08; 1 study, 110 participants; low-certainty evidence). Home modifications We found no trials of home modifications that measured falls as an outcome for task enablement and functional independence.
Authors' conclusions: We found high-certainty evidence that home fall-hazard interventions are effective in reducing the rate of falls and the number of fallers when targeted to people at higher risk of falling, such as having had a fall in the past year and recently hospitalised or needing support with daily activities. There was evidence of no effect when interventions were targeted to people not selected for risk of falling. Further research is needed to examine the impact of intervention components, the effect of awareness raising, and participant-interventionist engagement on decision-making and adherence. Vision improvement interventions may or may not impact the rate of falls. Further research is needed to answer clinical questions such as whether people should be given advice or take additional precautions when changing eye prescriptions, or whether the intervention is more effective when targeting people at higher risk of falls. There was insufficient evidence to determine whether education interventions impact falls.
Trial registration: ClinicalTrials.gov NCT00350389.
Copyright © 2023 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Conflict of interest statement
Lindy Clemson was an investigator in one trial of an environmental intervention to reduce falls which she did not review, and developed an assessment to identify home fall hazards that has been used in several trials. Susan Stark ran a trial of an environmental intervention to reduce falls and did not review her own trial. Alison C Pighills ran a trial of an environmental intervention to reduce falls and was an investigator on another trial; she did not review these trials. Nicola J Fairhall has no known conflicts of interest. Sarah E Lamb was an investigator on a trial of an environmental intervention to reduce falls and did not review this trial. She is on the Data and Safety Monitoring Committee for a pharmaceutical company, but this company is not involved in the development of environmental interventions for preventing falls. Catherine Sherrington has no known conflicts of interest. Jinnat Ali has no known conflicts of interest.
Figures
Comment in
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Preventing falls in older people: the evidence for environmental interventions and why history matters.Cochrane Database Syst Rev. 2023 Mar 10;3(3):ED000162. doi: 10.1002/14651858.ED000162. Cochrane Database Syst Rev. 2023. PMID: 36896853 Free PMC article. No abstract available.
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Environmental Interventions for Preventing Falls in Older People Living in the Community.Am Fam Physician. 2023 Nov;108(5):450-451. Am Fam Physician. 2023. PMID: 37983695 No abstract available.
References
References to studies included in this review
Campbell 2005 {published data only}
-
- ISRCTN15342873. VIP falls prevention trial. Interventions to prevent falls and injury in elderly people with impaired vision. www.isrctn.com/ISRCTN15342873 (first received 2 March 2005). [DOI: 10.1186/ISRCTN15342873] - DOI
-
- Jacobs R, Campbell AJ, Robertson MC. Randomized controlled trial of falls prevention in people 75 years and older with severe visual impairment [abstract]. American Academy of Optometry Meeting, 2005 Dec 8-12; San Diego (CA) 2005. [CENTRAL: CN-00634854]
-
- Kiata L, Kerse NM, Hughes WE, Hayman KJ, Robertson MC, La Grow SJ, et al. Agreement and compliance with advice on removing mats or rugs by older people with visual impairments. Journal of Visual Impairment & Blindness 2008;102(3):167-72.
Chu 2017 {published data only}
-
- Chu MM, Fong KN, Lit AC, Rainer TH, Cheng SW, Au FL, et al. An occupational therapy fall reduction home visit program for community-dwelling older adults in Hong Kong after an emergency department visit for a fall. Journal of the American Geriatrics Society 2017;37(1):5-13. - PubMed
Cockayne 2021a {published data only}
-
- Cockayne S, Pighills A, Adamson J, Fairhurst C, Crossland S, Drummond A, et al. Home environmental assessments and modification delivered by occupational therapists to reduce falls in people aged 65 years and over: the OTIS RCT. Health Technology Assessment 2021;25(46):1-117. [DOI: 10.3310/hta2546] - DOI - PMC - PubMed
-
- Cockayne S, Pighills A, Adamson J, Fairhurst C, Drummond A, Hewitt C, et al. Can occupational therapist-led home environmental assessment prevent falls in older people? A modified cohort randomised controlled trial protocol. BMJ Open 2018;8:e022488. [DOI: 10.1136/ bmjopen-2018-022488] - PMC - PubMed
-
- Cockayne S, Pighills A, Fairhurst C, Adamson J, Crossland S, Drummond A, et al. Home hazard assessment and environmental modification to prevent falls in older people: the OTIS trial [version 1; peer review: 1 approved, 1 approved with reservations]. F1000Research 2021;10(500):1-18. [DOI: 10.12688/f1000research.52313.1] - DOI
-
- ISRCTN22202133. Occupational therapist home assessment and modification for prevention of falls. www.isrctn.com/ISRCTN22202133 (first received 20 June 2016). [DOI: 10.1186/ISRCTN22202133] - DOI
Cumming 1999 {published data only}
-
- Cumming RG, Thomas M, Szonyi G, Frampton G, Salkeld G, Clemson L. Adherence to occupational therapist recommendations for home modifications for falls prevention. American Journal of Occupational Therapy 2001;55(6):641-8. [MEDLINE: ] - PubMed
-
- Cumming RG, Thomas M, Szonyi G, Salkeld G, O'Neill E, Westbury C, et al. Home visits by an occupational therapist for assessment and modification of environmental hazards: a randomized trial of falls prevention. Journal of the American Geriatrics Society 1999;47(12):1397-402. [MEDLINE: ] - PubMed
-
- Salkeld G, Cumming RG, O'Neill E, Thomas M, Szonyi G, Westbury C. The cost effectiveness of a home hazard reduction program to reduce falls among older persons. Australian and New Zealand Journal of Public Health 2000;24(3):265-71. [MEDLINE: ] - PubMed
Cumming 2007 {published data only}
-
- Cumming RG, Ivers R, Clemson L, Cullen J, Hayes MF, Tanzer M, et al. Improving vision to prevent falls in frail older people: a randomized trial. Journal of the American Geriatrics Society 2007;55(2):175-81. [MEDLINE: ] - PubMed
Day 2002 {published and unpublished data}
-
- Fitzharris MP, Day L, Lord SR, Gordon I, Fildes B. The Whitehorse NoFalls trial: effects on fall rates and injurious fall rates. Age & Ageing 2010;39(6):728-33. [MEDLINE: ] - PubMed
Haran 2010 {published data only}
-
- NCT00350389. VISIBLE study (Visual Intervention Strategy Incorporating Bifocal & Long-Distance Eyewear) (VISIBLE) [Randomised controlled falls prevention trial of plain distance glasses in elderly multifocal wearers]. clinicaltrials.gov/show/NCT00350389 (first received 10 July 2006).
Kamei 2015 {published and unpublished data}
-
- Kamei T, Fumiko K, Yuko Y, Yukako I, Rumi K, Tomoko S, et al. Effectiveness of a home hazard modification program for reducing falls in urban community-dwelling older adults: a randomized controlled trial. Japan Journal of Nursing Science 2015;12(3):184-97. - PubMed
Keall 2015 {published data only}
-
- Keall MD, Pierse N, Howden-Chapman P, Cunningham C, Cunningham M, Guria J, et al. Home modifications to reduce injuries from falls in the home injury prevention intervention (HIPI) study: a cluster-randomised controlled trial. Lancet 2015;385(9964):231-8. [DOI: 10.1016/S0140-6736(14)61006-0] - DOI - PubMed
Lannin 2007 {published data only}
Lin 2007 {published and unpublished data}
-
- Lin MR, Wolf SL, Hwang HF, Gong SY, Chen CY. A randomized, controlled trial of fall prevention programs and quality of life in older fallers. Journal of the American Geriatrics Society 2007;55(4):499-506. [MEDLINE: ] - PubMed
Lockwood 2019 {published data only}
McKiernan 2005 {published data only}
-
- McKiernan FE. A simple gait-stabilizing device reduces outdoor falls and nonserious injurious falls in fall-prone older people during the winter. Journal of the American Geriatrics Society 2005;53(6):943-7. [MEDLINE: ] - PubMed
Nikolaus 2003 {published data only}
-
- Nikolaus T, Bach M. Preventing falls in community-dwelling frail older people using a home intervention team (HIT): results from the randomized falls-HIT trial. Journal of the American Geriatrics Society 2003;51(3):300-5. [MEDLINE: ] - PubMed
-
- Nikolaus T, Specht-Leible N, Bach M, Wittmann-Jennewein C, Oster P, Schlierf G. Effectiveness of hospital-based geriatric evaluation and management and home intervention team (GEM-HIT). Rationale and design of a 5-year randomized trial. Zeitschrift fur Gerontologie und Geriatrie 1995;28(1):47-53. [MEDLINE: ] - PubMed
Pardessus 2002 {published data only}
-
- Pardessus V, Puisieux F, Di P, Gaudefroy C, Thevenon A, Dewailly P. Benefits of home visits for falls and autonomy in the elderly: a randomized trial study. American Journal of Physical Medicine and Rehabilitation 2002;81(4):247-52. [MEDLINE: ] - PubMed
Perry 2008 {published data only}
-
- Perry SD, Radtke A, McIlroy WE, Fernie GR, Maki BE. Efficacy and effectiveness of a balance-enhancing insole. Journals of Gerontology Series A: Biological Sciences & Medical Sciences 2008;63(6):595-602. - PubMed
Pighills 2011 {published and unpublished data}07575807
-
- ISRCTN07575807. Reducing home hazards to prevent falls in older people [Environmental assessment and modification to prevent falls in older people: a randomised controlled single centre trial]. controlled-trials.com/ISRCTN07575807 (first received 10 May 2009).
-
- Pighills A, Torgerson DJ, Sheldon T. Publicity does not increase recruitment to falls prevention trials: the results of two quasi-randomized trials. Journal of Clinical Epidemiology 2009;62(12):1332-5. - PubMed
-
- Pighills AC, Torgerson DJ, Sheldon TA, Drummond AE, Bland JM. Environmental assessment and modification to prevent falls in older people. Journal of the American Geriatrics Society 2011;59(1):26-33. [MEDLINE: ] - PubMed
Stark 2021 {published data only}
Stevens 2001 {published data only}
-
- Stevens M, Holman CD, Bennett N, Klerk N. Preventing falls in older people: outcome evaluation of a randomized controlled trial. Journal of the American Geriatrics Society 2001;49(11):1448-55. [MEDLINE: ] - PubMed
-
- Stevens M, Holman CD, Bennett N. Preventing falls in older people: impact of an intervention to reduce environmental hazards in the home. Journal of the American Geriatrics Society 2001;49(11):1442-7. [MEDLINE: ] - PubMed
Tchalla 2013 {published data only}
-
- Tchalla AE, Lachal F, Cardinaud N, Saulnier I, Rialle V, Preux PM, et al. Preventing and managing indoor falls with home-based technologies in mild and moderate Alzheimer's disease patients: pilot study in a community dwelling. Dementia & Geriatric Cognitive Disorders 2013;36(3/4):251-61. - PubMed
Thomas 2018 {published data only}
Wang 2019 {published and unpublished data}
-
- NCT02819011. OHI - randomized control trial to evaluate efficacy, acceptability, and perception of benefit of an innovative custom AFO. clinicaltrials.gov/ct2/show/NCT02819011 (first received 30 June 2016).
References to studies excluded from this review
Casteel 2020 {published data only}
Deems‐Dluhy 2021 {published data only}
-
- Deems-Dluhy S, Hoppe-Ludwig S, Mummidisetty CK, Semik P, Heinemann AW, Jayaraman A. Microprocessor controlled knee ankle foot orthosis (KAFO) vs stance control vs locked KAFO: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation 2021;102:233-44. [DOI: 10.1016/j.apmr.2020.08.013] - DOI - PubMed
Ferrer 2014 {published data only}
Greenberg 2020 {published data only}
Hill 2019 {published data only}
-
- Hill AM, McPhail SM, Haines TP, Morris ME, Etherton-Beer C, Shorr R, et al. Falls after hospital discharge: a randomized clinical trial of individualized multimodal falls prevention education. Journals of Gerontology Series A: Biological Sciences & Medical Sciences 2019;74(9):1511-7. [PMID: ] - PMC - PubMed
Johansson 2018 {published data only}
-
- Johansson E, Jonsson H, Dahlberg R, Patomella AH. The efficacy of a multifactorial falls-prevention programme, implemented in primary health care. British Journal of Occupational Therapy 2018;81(8):474-81. [DOI: 10.1177/0308022618756303] - DOI
Lee 2013 {published data only}
-
- Lee H-C, Chang K-C, Tsauo J-Y, Huang Y-C, Lin SI. Effects of a multifactorial fall prevention program on fall incidence and physical function in community-dwelling older adults with risk of falls. Archives Physical Medicine & Rehabilitation 2013;94(4):606-15. [PMID: ] - PubMed
Liu 2020 {published data only}
Luck 2013 {published data only}
Moller 2014 {published data only}
Oddsson 2020 {published data only}
-
- Oddsson L, Bisson T, Cohen H, Jacobs L, Khoshnoodi M, Kung D, et al. The effects of a wearable sensory prosthesis on gait and balance function after 10 weeks of use in persons with peripheral neuropathy and high fall risk – the walk2Wellness trial. Aging Neuroscience 2020;12:592751. [DOI: 10.3389/fnagi.2020.592751] - DOI - PMC - PubMed
Tannenbaum 2019 {published data only}
-
- Tannenbaum C, Fritel X, Halme A, den Heuvel E, Jutai J, Wagg A. Long-term effect of community-based continence promotion on urinary symptoms, falls and healthy active life expectancy among older women: cluster randomised trial. Age and Ageing 2019;48(4):526-32. [DOI: 10.1093/ageing/afz038] - DOI - PMC - PubMed
Tiefenbachova 2019 {published data only}
-
- Tiefenbachová P, Zeleníková R. The effect of educational intervention by nurses on home environmental risk factors for falls. Central European Journal of Nursing and Midwifery 2019;10(2):1019-25. [DOI: 10.15452/CEJNM.2019.10.0009] - DOI
Wesson 2013 {published data only}
Yamashita 2019 {published data only}
-
- Yamashita T, Yamashita K, Rinoie C, Takase Y, Sato M, Yamada K, et al. Improvements in lower-limb muscle strength and foot pressure distribution with foot care in frail elderly adults: a randomized controlled trial from Japan. BMC Geriatrics 2019;18:83. [DOI: 10.1186/s12877-019-1097-z] - DOI - PMC - PubMed
References to studies awaiting assessment
Stark 2016 {published data only}
-
- Stark S, Keglovits M, Somerville E. A randomized controlled feasibility trial of tailored home modifications to improve activities of daily living. American Journal of Occupational Therapy 2016;70(4 Suppl 1):7011520290p1. [DOI: 10.5014/ajot.2018.021774] - DOI
References to ongoing studies
Hatton 2019 {published data only}
-
- ACTRN12617000543381. Do different shoe insole surfaces affect balance and walking in adults with diabetic peripheral neuropathy? A randomised controlled trial. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372682&isRe... (first received 11 April 2017).
Additional references
Aliberti 2019
Aplin 2015
Campbell 1990
-
- Campbell AJ, Borrie MJ, Spears GF, Jackson SL, Brown JS, Fitzgerald JL. Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. Age and Ageing 1990;19:136-41. - PubMed
Canning 2015
Carnemolla 2019
Clemson 2003
-
- Clemson L, Manor D, Fitzgerald MH. Behavioral factors contributing to older adults falling in public places. OTJR: Occupation, Participation and Health 2003;23(3):107-17.
Clemson 2008
-
- Clemson L, Mackenzie L, Ballinger C, Close JCT, Cumming RG. Environmental interventions to prevent falls in community-dwelling older people: a meta-analysis of randomized trials. Journal of Aging and Health 2008;20(8):954-71. - PubMed
Clemson 2021
-
- Clemson L, Pighills A. Environmental interventions to prevent falls at home and in the community. In: Lord S, Sherrington C, Naganathan V, editors(s). Falls in Older People: Risk factors, Strategies for Prevention and Implications for Practice. Cambridge: Cambridge University Press, 2021:360-77. [DOI: 10.1017/9781108594455.024] - DOI
Cochrane Norway 2017
-
- Cochrane Norway. How to write a plain language summary of a Cochrane intervention review. www.ahajournals.org/doi/10.1161/circ.114.suppl_18.II_525-c (accessed prior to 11 January 2023).
Cockayne 2021b
-
- Cockayne S, Pighills A, Adamson J, Fairhurst C, Crossland S, Drummond A. Home environmental assessments and modification delivered by occupational therapists to reduce falls in people aged 65 years and over: the OTIS RCT. Health Technology Assessment 2021;25(46):1-118. [DOI: 10.3310/hta25460] [ISSN: 1366-5278] - DOI - PMC - PubMed
Deandrea 2010
-
- Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology 2010;21(5):658-68. - PubMed
Díaz‐Arribas 2017
EuroQol Research Foundation
-
- EuroQol Research Foundation. EQ-5D. euroqol.org/ (accessed 2 February 2019).
Fange 2005
-
- Fange A, Iwarsson S. Changes in accessibility and usability in housing: an exploration of the housing adaptation process. Occupational Therapy International 2005;12(1):44-59. - PubMed
Ferrari 2012
Gillespie 2012
Gitlin 2003
-
- Gitlin LP. Conducting research on home environments: lessons learned and new directions. Gerontologist 2003;45(5):628-37. - PubMed
Gitlin 2009
-
- Gitlin L. Environmental adaptations for older adults and their families in the home and community. In: Soderback I, editors(s). International Handbook of Occupational Therapy Interventions. London: Springer, 2009.
Guyatt 2011
Hannan 2010
-
- Hannan MT, Gagnon MM, Aneja J, Jones RN, Cupples LA, Lipsitz LA, et al. Optimizing the tracking of falls in studies of older participants: comparison of quarterly telephone recall with monthly falls calendars in the MOBILIZE Boston Study. American Journal of Epidemiology 2010;171(9):1031-6. - PMC - PubMed
He 2016
-
- He W, Goodkind D, Kowal P, US Census Bureau. An Aging World: 2015. Washington, DC: International Population Reports. US Government Publishing Office, 2016.
Herdman 2011
Higgins 2011
-
- Higgins JPT, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from training.cochrane.org/handbook/archive/v5.1/.
Hill 2018
Hopewell 2018
-
- Hopewell S, Adedire O, Copsey BJ, Boniface GJ, Sherrington C, Clemson L, et al. Mutlifactorial and multiple component interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews 2018, Issue 7. Art. No: CD012221. [DOI: 10.1002/14651858.CD012221.pub2] - DOI - PMC - PubMed
Horowitz 2013
-
- Horowitz BP, Nochajski SM, Schweitzer JA. Occupational therapy community practice and home assessments: use of the home safety self-assessment tool (HSSAT) to support aging in place. Occupational Therapy in Health Care 2013;27(3):216-27. - PubMed
IBM Corp 2019 [Computer program]
-
- IBM SPSS Statistics for Windows. Version 24.0. Armonk, NY: IBM Corp, 2019.
Iliffe 2015
Iwarsson 2009
-
- Iwarsson S, Horstmann V, Carlsson G, Oswald F, Wahl HW. Person-environment fit predicts falls in older adults better than the consideration of environmental hazards only. Clinical Rehabilitation 2009;23(6):558-67. - PubMed
Karlsson 2013
Keglovits 2020
-
- Keglovits M, Clemson L, Hu YL, Nguyen A, Neff AJ, Mandelbaum C, et al. A scoping review of fall hazards in the homes of older adults and development of a framework for assessment and intervention. Australian Occupational Therapy Journal 2020;67(5):470-8. [DOI: 10.1111/1440-1630.12682] - DOI - PubMed
Kellog International Work Group 1987
-
- Kellog International Work Group. The prevention of falls in later life. A report of the Kellogg International Work Group on the Prevention of Falls by the Elderly. Danish Medical Bulletin 1987;34(Suppl 4):1-24. - PubMed
Lamb 2005
-
- Lamb SE, Jørstad-Stein EC, Hauer K, Becker C, Prevention of Falls Network Europe and Outcomes Census Group. Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus. Journal of the American Geriatrics Society 2005;53(9):1618-22. - PubMed
Lamb 2007
-
- Lamb SE, Hauer K, Becker C. Manual for the fall prevention classification system. www.profane.eu.org/documents/Falls_Taxonomy.pdf (accessed prior to 18 December 2018).
Law 1997
-
- Law M, Cooper BA, Strong S, Stewart D, Rigby PJ, Letts LT. The person environment occupation model: a transactive approach to occupational therapy. Canadian Journal of Occupational Therapy 1997;63:9-23. - PubMed
Leavy 2015
Lee 2021
Lefebvre 2019
-
- Lefebvre C, Glanville J, Briscoe S, Littlewood A, Marshall C, Metzendorf MI, et al. Chapter 4: Searching for and selecting studies. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 6.0 (updated July 2019). Cochrane, 2019. Available from training.cochrane.org/handbook/archive/v6.
Lord 2006
-
- Lord SR, Menz HB, Sherrington C. Home environment risk factors for falls in older people and the efficacy of home modifications. Age and Ageing 2006;35(Suppl 2):ii55-9. - PubMed
Lusardi 2017
Makino 2018
-
- Makino K, Makizako H, Doi T, Tsutsumimoto K, Hotta R, Nakakubo S, et al. Impact of fear of falling and fall history on disability incidence among older adults: prospective cohort study. International Journal of Geriatric Psychiatry 2018;33(4):658-62. - PubMed
Microsoft Excel [Computer program]
-
- Microsoft Excel. Microsoft Corporation, 2018.
Moreland 2020
Nahemow 2000
-
- Nahemow L. The ecological theory of aging: Powell Lawton's legacy. In: Rubinstein RL, Moss M, Kieban M, Lawton MP, editors(s). The Many Dimensions of Aging. New York: Springer, 2000:22-40.
Peterson 2008
-
- Peterson EW, Clemson L. Understanding the role of occupational therapy in fall prevention for community dwelling older adults. OT Practice 2008;13(3):CEA0208.
Pighills 2016
-
- Pighills A, Ballinger C, Pickering R, Chan S. A critical review of the effectiveness of environmental assessment and modification in the prevention of falls amongst community dwelling older people. British Journal of Occupational Therapy 2016;79(3):133–43.
Pighills 2019
Pighills 2021
-
- Pighills A, Clemson L. Environmental risk factors for falls. In: Lord S, Sherrington C, Naganathan V, editors(s). Falls in Older People: Risk Factors, Strategies for Prevention and Implications for Practice. Cambridge: Cambridge University Press, 2021:202-10. [DOI: 10.1017/9781108594455.013] - DOI
Prabhakaran 2020
Review Manager 2020 [Computer program]
-
- Review Manager 5 (RevMan 5). Version 5.4. Copenhagen: The Cochrane Collaboration, 2020.
Robertson 2005
-
- Robertson MC, Campbell AJ, Herbison P. Statistical analysis of efficacy in falls prevention trials. Journals of Gerontology Series A: Biological Sciences & Medical Sciences 2005;60(4):530-4. - PubMed
Rubenstein 2006
-
- Rubenstein L. Falls in older people: epidemiology, risk factors and strategies for prevention. Age and Ageing 2006;35-S2:37-41. - PubMed
Salkeld 2000
-
- Salkeld G, Cumming RG, O'Neill R, Thomas M, Szonyi G, Westbury C. The cost effectiveness of a home hazard reduction program to reduce falls among older persons. Australian and New Zealand Journal of Public Health 2000;24(3):265-71. - PubMed
Sanford 2004
-
- Sanford JA, Jones M, Daviou P, Grogg K, Butterfield T. Using telerehabilitation to identify home modification needs. Assistive Technology 2004;16(1):43-53. - PubMed
Santesso 2014
Schünemann 2017
-
- Schünemann HJ, Oxman AD, Higgins JPT, Vist GE, Glasziou P, Guyatt GH on behalf of the Cochrane GRADEing Methods Group (formerly Applicability and Recommendations Methods Group) and the Cochrane Statistical Methods Group. Chapter 11: Completing ‘Summary of findings’ tables and grading the confidence in or quality of the evidence. In: Higgins JPT, Churchill R, Chandler J, Cumpston MS, editor(s). Cochrane Handbook for Systematic Reviews of Interventions version 5.2.0 (updated June 2017). Cochrane, 2017. Available from training.cochrane.org/handbook/archive/v5.2.
Schünemann 2022
-
- Schünemann HJ, Vist GE, Higgins JPT, Santesso N, Deeks JJ, Glasziou P, et al. Chapter 15: Interpreting results and drawing conclusions. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.3 (updated February 2022). Cochrane, 2022. Available from training.cochrane.org/handbook.
Shi 2014
-
- Shi J, Zhou BY, Tao YK, Yu PL, Zhang CF, Qin ZH, et al. Incidence and associated factors for single and recurrent falls among the elderly in an urban community of Beijing. Biomedical & Environmental Sciences 2014;27(12):939-49. - PubMed
Smeeth 2002
-
- Smeeth L, Ng ES. Intraclass correlation coefficients for cluster randomized trials in primary care: data from the MRC Trial of the Assessment and Management of Older People in the Community. Controlled Clinical Trials 2002;23(4):409-21. - PubMed
Stark 2009
Stevens 2014
Verheyden 2013
Verma 2016
Walters 2005
Wellecke 2022
-
- Wellecke C, D'Cruz K, Winkler D, Douglas J, Goodwin J, Davis E, et al. Accessible design features and home modifications to improve physical housing accessibility: a mixed-methods survey of occupational therapists. Disability and Health Journal 2022;101281:1-8. [DOI: 10.1016/j.dhjo.2022.101281] - DOI - PubMed
WHO 2004
-
- World Health Organization. Assistive devices and technologies. www.who.int/disabilities/technology/en/ (accessed 20 November 2017).
Williams 2015
-
- Williams JS, Kowal P, Hestekin H, O'Driscoll T, Peltzer K, Yawson A, et al. Prevalence, risk factors and disability associated with fall-related injury in older adults in low- and middle-income countries: results from the WHO Study on global AGEing and adult health (SAGE). BMC Medicine 2015;13:147. [DOI: 10.1186/s12916-015-0390-8] - DOI - PMC - PubMed
Zecevic 2006
-
- Zecevic AA, Salmoni AW, Speechley M, Vandervoort AA. Defining a fall and reasons for falling: comparisons among the views of seniors, health care providers, and the research literature. Gerontologist 2006;46(3):367-76. - PubMed
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