Environmental interventions to prevent falls in community-dwelling older people: a meta-analysis of randomized trials

Clemson, Lindy, Mackenzie, Lynette, Ballinger, Claire, Close, Jacqueline C.T. and Cumming, Robert G. (2008) Environmental interventions to prevent falls in community-dwelling older people: a meta-analysis of randomized trials. Journal of Aging and Health, 20 (8), 954-971. (doi:10.1177/0898264308324672). (PMID:18815408)

Abstract

Objective. This study seeks to determine the efficacy of environmental interventions in reducing falls in community-dwelling older people.

Method. A systematic review and meta-analysis of randomized trials was performed.

Results. Pooled analysis of six trials (N = 3,298) demonstrated a 21% reduction in falls risk (relative risk [RR] = 0.79; 0.65 to 0.97). Heterogeneity was attributable to the large treatment effect of one trial. Analysis of a subgroup of studies with participants at high risk of falls (four trials, n = 570) demonstrated a clinically significant 39% reduction of falls (RR = 0.61; 0.47 to 0.79), an absolute risk difference of 26% for a number needed to treat four people.

Discussion. Home assessment interventions that are comprehensive, are well focused, and incorporate an environmental-fit perspective with adequate follow-up can be successful in reducing falls with significant effects. The highest effects are associated with interventions that are conducted with high-risk groups.

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