CLINICAL QUESTION

What interventions reduce falls among older adults living in care facilities?

EVIDENCE-BASED ANSWER

Multifactorial interventions not tailored to individual needs (ie, defined as two or more strategies based on general risk profiles) probably have little or no effect on fall rate and may only modestly reduce overall fall risk. In contrast, tailored interventions that are customized to residents' needs, especially those who have dementia, and are implemented with staff engagement reduce fall rate after 6 to 12 months and fall risk after 10 to 12 months.¹ (Strength of Recommendation [SOR]: B, inconsistent or limited-quality patient-oriented evidence.)

Active exercise, including moderate- or low-intensity group exercise or physical activity for more than 1 hour/week for residents who are independent and ambulatory, decreases the fall rate, but these benefits are not sustained if exercise is discontinued.¹ (SOR: B, inconsistent or limited-quality patient-oriented evidence.)

Vitamin D supplementation, with or without calcium, probably reduces the rate of falls among institutionalized older adults with vitamin D deficiency.¹ (SOR: B, inconsistent or limited-quality patient-oriented evidence.)