Thoughts on effective falls prevention intervention on a population basis
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- Skelton, D.A. & Todd, C.J. J Public Health (2005) 13: 196. doi:10.1007/s10389-005-0118-x
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The prevention of accidental injury associated with falls in older people is a public health target in many countries. Older people make up a large and increasing percentage of the population. As people grow older, they are at increasing risk of falling and suffering injury from falling. Falls are not an inevitable result of ageing, but they are the most serious and frequent home accident among older people. Falls are a major reason for admission to hospital and residential care setting, even when no serious injury has occurred. Falls are therefore costly for society as well as causing considerable suffering, morbidity and mortality. Unless concerted action is taken, the number of falls and injuries is likely to increase even further over the next 25–30 years. A number of strategies and interventions targeted at individuals has been shown to work, but population-based strategies have not been well evaluated. Review of the literature confirms that fall prevention programmes can be effective in reducing the numbers of older people who fall and the rate at which people fall. Targeted strategies aimed at behaviour change and risk modification for those living in the community appear to be most promising. Multidisciplinary multi-factorial intervention programmes that include risk-factor assessment, screening, and appropriate intervention have been shown to be effective. New integrated falls services will help to provide both effective interventions and long-term support to regain mobility, independence and confidence. Health and social care statutory agencies need to work together to prioritise fall prevention as part of their overall strategy for promoting healthy ageing. Coherent multi-disciplinary programmes can be developed at the national level, but these should be implemented with national data collection mechanisms to evaluate interventions. The evidence is still scant for wider population-based approaches to falls prevention. This paper will consider some of the evidence on effectiveness of falls interventions delivered on a population basis.