USPSTF issues Recommendations regarding Interventions to Prevent Falls in Community-Dwelling Older Adults

The USPSTF recommendation statement, published in the Journal of the American Medical Association (JAMA), recommends exercise interventions for preventing falls in community-dwelling older adults at risk for falls and states that recommendations for multifactorial interventions should be individualized.

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

Eighty-three fair- to good-quality randomized clinical trials comprising 48,839 participants examined the effectiveness of 6 fall prevention interventions, focusing on the two most studied intervention types: exercise (37 studies, with 16,117 adults) and multifactorial (28 studies, with 27,784 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, the 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 the 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, MD, PhD, MPH, said in a statement.

To summarize, to achieve the benefit of fall prevention interventions, recommended interventions must be available, accessible, and provided equitably.

The USPSTF recommendation statement is a crucial guideline for healthcare providers, policymakers, and community organizations striving to address the pervasive issue of falls among older adults. By advocating for evidence-based interventions tailored to the unique needs of this population, the task force aims to mitigate the significant burden of falls and promote the health and well-being of older adults living in the community.

Reference:

US Preventive Services Task Force. Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement. JAMA. Published online June 04, 2024. doi:10.1001/jama.2024.8481