Osteoporosis International

, Volume 24, Issue 3, pp 747–762

Prevention of falls in the elderly—a review

  • M. K. Karlsson
  • H. Magnusson
  • T. von Schewelov
  • B. E. Rosengren
Review

DOI: 10.1007/s00198-012-2256-7

Cite this article as:
Karlsson, M.K., Magnusson, H., von Schewelov, T. et al. Osteoporos Int (2013) 24: 747. doi:10.1007/s00198-012-2256-7

Abstract

The proportion of elderly in the society increases and fall frequency increases with advancing age. Many falls result in fractures and also soft tissue injuries, longstanding pain, functional impairment, reduced quality of life, increased mortality, and excess in healthcare costs. Due to the magnitude of these negative effects, a variety of single- and multicomponent fall-preventive intervention programs has been initiated.This review identifies programs that, in randomized controlled trials (RCTs), have been shown with fall-reductive effects.The most effective strategies in community-dwelling elderly include regular physical training with program that includes several different training modalities. Modification of the overall or patient-specific risk factor profile in home hazard modification program has been proven to decrease fall risk in community-living elderly. The elderly in the community benefit also from wearing antislip shoe devices when walking in icy conditions, from adjustment of psychotropic medication, and from structured modification of multipharmacy. If vitamin D levels in blood are low, supplementation is beneficial as is the first eye cataract surgery and pacemaker implantation in patients with cardioinhibitory carotid sinus hypersensitivity. In addition to modification of specific risk factors, generalized and individualized multifactorial preventive programs, all including some sort of physical training, have been found to decrease the fall risk. In summary, there is now strong evidence in the literature that structured fall-preventive programs in the elderly, especially in high-risk groups, are beneficial in reducing both the number of fallers and the number of falls in community.

Keywords

Elderly Epidemiology Falls Fractures Prevention Randomized controlled trials 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2012

Authors and Affiliations

  • M. K. Karlsson
    • 1
    • 2
  • H. Magnusson
    • 1
  • T. von Schewelov
    • 1
  • B. E. Rosengren
    • 1
  1. 1.Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics and Clinical Sciences, Skåne University HospitalLund UniversityMalmöSweden
  2. 2.Department of OrthopedicsSkåne University HospitalMalmöSweden