Journal of Applied Research in Intellectual Disabilities, 34(1), 2021, pp.274-285.
Publisher:
Wiley
Background: The prevalence of falls involving people with intellectual disabilities (ID) is high in comparison with the general population. There has been little evidence to date on the contributing risk factors. The objective of this review was to identify risk factors for people with intellectual disabilities. Method: Literature searches were conducted using electronic databases to explore evidence on the subject, and narrative synthesis was employed to analyse the results. Results: Seven risk factors were identified: decreasing physical ability, epilepsy, paretic conditions, impulsiveness, previous falls, incontinence and non‐use of assistive equipment. Thematic analysis identified factors across the four concepts: the person, the situation, ongoing and protective factors. Conclusion: Factors for falls involving people with intellectual disabilities are dynamic and multifactorial. Some are specific to the population; however, further research is required to develop the understanding of the possible reasons. The findings have implications across policy, education, practice and research.
(Edited publisher abstract)
Background: The prevalence of falls involving people with intellectual disabilities (ID) is high in comparison with the general population. There has been little evidence to date on the contributing risk factors. The objective of this review was to identify risk factors for people with intellectual disabilities. Method: Literature searches were conducted using electronic databases to explore evidence on the subject, and narrative synthesis was employed to analyse the results. Results: Seven risk factors were identified: decreasing physical ability, epilepsy, paretic conditions, impulsiveness, previous falls, incontinence and non‐use of assistive equipment. Thematic analysis identified factors across the four concepts: the person, the situation, ongoing and protective factors. Conclusion: Factors for falls involving people with intellectual disabilities are dynamic and multifactorial. Some are specific to the population; however, further research is required to develop the understanding of the possible reasons. The findings have implications across policy, education, practice and research.
(Edited publisher abstract)
Draws on recent research to summarise what is known about falls and falls prevention amongst older people with sight loss. It explores the implications of research findings for action to address and reduce the risk of falls among older people with sight loss and suggests key issues for health and social care professionals to consider when working with older people, many of whom may have sight loss, and for sight loss specialists to consider when addressing individuals’ risks of falls.
(Publisher abstract)
Draws on recent research to summarise what is known about falls and falls prevention amongst older people with sight loss. It explores the implications of research findings for action to address and reduce the risk of falls among older people with sight loss and suggests key issues for health and social care professionals to consider when working with older people, many of whom may have sight loss, and for sight loss specialists to consider when addressing individuals’ risks of falls.
(Publisher abstract)
Subject terms:
older people, falls, visual impairment, prevention;
Journal of Assistive Technologies, 6(3), 2012, pp.202-215.
Publisher:
Emerald
This review explored the recent literature regarding the development of fall detector technology. The review was part of a service evaluation on the use of fall detectors across the region funded by NHS West Midlands. The authors also discuss the application and use of products designed to detect falls and alert help from end-user and health and social care staff perspectives. The literature of robust evidence regarding different approaches to technology in the management and detection of falls. Users had mixed views regarding the use of fall detectors, with some people having concerns about privacy, lack of human contact, user-friendliness and appropriate training, whilst others clearly identified the benefits of detecting falls and raising an alert. The implications of these findings
This review explored the recent literature regarding the development of fall detector technology. The review was part of a service evaluation on the use of fall detectors across the region funded by NHS West Midlands. The authors also discuss the application and use of products designed to detect falls and alert help from end-user and health and social care staff perspectives. The literature of the last ten years was reviewed and the main themes from the literature summarised. While there is a wide variety of new technology applied to fall detectors in development, the range of technologies currently available through health and social services to users is limited. Health and social care staff appear to be less convinced of the benefits of fall detectors than end-users. There was also a lack of robust evidence regarding different approaches to technology in the management and detection of falls. Users had mixed views regarding the use of fall detectors, with some people having concerns about privacy, lack of human contact, user-friendliness and appropriate training, whilst others clearly identified the benefits of detecting falls and raising an alert. The implications of these findings for practice are discussed.
Subject terms:
user views, assistive technology, attitudes, falls;
This article examines the evidence on the effect of bedrails on falls and injury, based on a recent systematic literature review. It also discusses why so many opinion pieces on bedrails adopt an extremely negative perspective. Patients' opinions on bedrails, ethical considerations and implications for practice are also explored.
This article examines the evidence on the effect of bedrails on falls and injury, based on a recent systematic literature review. It also discusses why so many opinion pieces on bedrails adopt an extremely negative perspective. Patients' opinions on bedrails, ethical considerations and implications for practice are also explored.
Objective: falls among older adults are common and can have devastating consequences. A novel task-specific exercise modality, gait adaptability training (GAT), has shown promising preventive effects. This systematic review and meta-analysis synthesise the evidence regarding GATs effect on falls and fall-related fractures in community-dwelling older adults. Methods: electronic databases (PubMed, EMBASE, CINAHL, CENTRAL) were systematically searched from inception to 18 June 2020. Additional sources include searches of trial registrations, manual screening of reference lists and requests to experts. We included randomised controlled trials (RCTs) evaluating the effect of GAT on falls with at least 6-month follow-up among community-dwelling people aged 60+ years. Two reviewers independently 0.39–0.81, I2 = 0.00%; moderate certainty; seven RCTs). Moreover, proportion with fall-related fractures and proportion of fallers was reduced by 81% (risk ratio [RR] 0.19, 95% CI 0.06–0.56, I2 = 0.00%; very low certainty; two RCTs) and 43% (RR 0.57, 95% CI 0.4–to 0.8, I2 = 47.08%; low certainty; 11 RCTs), respectively. Conclusions: our results show that GAT significantly reduces the number of falls
(Edited publisher abstract)
Objective: falls among older adults are common and can have devastating consequences. A novel task-specific exercise modality, gait adaptability training (GAT), has shown promising preventive effects. This systematic review and meta-analysis synthesise the evidence regarding GATs effect on falls and fall-related fractures in community-dwelling older adults. Methods: electronic databases (PubMed, EMBASE, CINAHL, CENTRAL) were systematically searched from inception to 18 June 2020. Additional sources include searches of trial registrations, manual screening of reference lists and requests to experts. We included randomised controlled trials (RCTs) evaluating the effect of GAT on falls with at least 6-month follow-up among community-dwelling people aged 60+ years. Two reviewers independently screened studies against eligibility criteria, extracted relevant information and appraised studies for bias. Random-effects meta-analytic models were employed to pool effect estimates. Results: eleven studies with 1,131 participants were included. A meta-analysis in which an outlier study was excluded showed that GAT reduces fall rates by 42% (incidence rate ratio 0.58, 95% confidence interval [CI] 0.39–0.81, I2 = 0.00%; moderate certainty; seven RCTs). Moreover, proportion with fall-related fractures and proportion of fallers was reduced by 81% (risk ratio [RR] 0.19, 95% CI 0.06–0.56, I2 = 0.00%; very low certainty; two RCTs) and 43% (RR 0.57, 95% CI 0.4–to 0.8, I2 = 47.08%; low certainty; 11 RCTs), respectively. Conclusions: our results show that GAT significantly reduces the number of falls and prevents fall-related fractures in older community dwellers. GAT is a promising and feasible exercise modality; however, studies of high quality should be conducted to support a robust conclusion.
(Edited publisher abstract)
Subject terms:
falls, training, older people, prevention, physical exercise;
Objective To systematically review and critically appraise prognostic models for falls in community-dwelling older adults. Eligibility criteria Prospective cohort studies with any follow-up period. Studies had to develop or validate multifactorial prognostic models for falls in community-dwelling older adults (60+ years). Models had to be applicable for screening in a general population setting. of participants ranged from 67.5 to 83.0 years. Falls incidences varied from 5.9% to 59%. Included studies reported 69 developed and three validated prediction models. Most frequent falls predictors were prior falls, age, sex, measures of gait, balance and strength, along with vision and disability. The area under the curve was available for 40 (55.6%) models, ranging from 0.49 to 0.87. Validated models’ The area under the curve ranged from 0.62 to 0.69. All models had a high risk of bias, mostly due to limitations in statistical methods, outcome assessments and restrictive eligibility criteria. Conclusions An abundance of prognostic models on falls risk have been developed, but with a wide range in discriminatory performance. All models exhibited a high risk of bias rendering them unreliable
(Edited publisher abstract)
Objective To systematically review and critically appraise prognostic models for falls in community-dwelling older adults. Eligibility criteria Prospective cohort studies with any follow-up period. Studies had to develop or validate multifactorial prognostic models for falls in community-dwelling older adults (60+ years). Models had to be applicable for screening in a general population setting. Information source MEDLINE, EMBASE, CINAHL, The Cochrane Library, PsycINFO and Web of Science for studies published in English, Danish, Norwegian or Swedish until January 2020. Sources also included trial registries, clinical guidelines, reference lists of included papers, along with contacting clinical experts to locate published studies. Data extraction and risk of bias Two authors performed all review stages independently. Data extraction followed the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies checklist. Risk of bias assessments on participants, predictors, outcomes and analysis methods followed Prediction study Risk Of Bias Assessment Tool. Results After screening 11 789 studies, 30 were eligible for inclusion (n=86 369 participants). Median age of participants ranged from 67.5 to 83.0 years. Falls incidences varied from 5.9% to 59%. Included studies reported 69 developed and three validated prediction models. Most frequent falls predictors were prior falls, age, sex, measures of gait, balance and strength, along with vision and disability. The area under the curve was available for 40 (55.6%) models, ranging from 0.49 to 0.87. Validated models’ The area under the curve ranged from 0.62 to 0.69. All models had a high risk of bias, mostly due to limitations in statistical methods, outcome assessments and restrictive eligibility criteria. Conclusions An abundance of prognostic models on falls risk have been developed, but with a wide range in discriminatory performance. All models exhibited a high risk of bias rendering them unreliable for prediction in clinical practice. Future prognostic prediction models should comply with recent recommendations such as Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis.
(Edited publisher abstract)
Subject terms:
falls, communities, older people, models, systematic reviews;
Background: Post-hospital falls constitute a significant health concern for older adults who have been recently discharged from the hospital. Objectives: To systematically summarise existing evidence on the incidence and risk factors for post-hospital falls among older adults. Methods: A systematic review and meta-analysis was conducted. Six electronic databases were searched to identify cohort studies investigating the incidence and risk factors for post-hospital falls in older adults. The incidence and risk factors for post-hospital falls were extracted. The meta-analysis was used to calculate pooled incidences and 95% confidence intervals (CI). The meta-regression and subgroup meta-analysis were conducted to explore sources of heterogeneity in incidence proportions across the eligible studies. A qualitative synthesis was performed for the post-hospital falls risk factors. Results: Eighteen studies from eight countries (n = 9,080,568) were included. The pooled incidence proportion of any and recurrent post-hospital falls was 14% (95% CI: 13%-15%) and 10% (95% CI: 5%-14%), respectively. Follow-up period, study quality, study country, setting, percentage of female subjects, percentage of subjects with previous falls and the primary data collection method for falls significantly contributed to the 64.8% of the heterogeneity in incidence proportions. Twenty-six risk factors for post-hospital falls were identified in the eligible studies, where biological factors were the most commonly identified factors. The highest risks were reported for previous falls, previous fractures, delirium and neurological diseases. Conclusion: The findings of this study suggested future post-hospital falls prevention should prioritise the needs of older adults with the dominant risk factors. Further investigations into the period-specific incidence and socioeconomic and environmental risk factors for post-hospital falls are also required.
(Edited publisher abstract)
Background: Post-hospital falls constitute a significant health concern for older adults who have been recently discharged from the hospital. Objectives: To systematically summarise existing evidence on the incidence and risk factors for post-hospital falls among older adults. Methods: A systematic review and meta-analysis was conducted. Six electronic databases were searched to identify cohort studies investigating the incidence and risk factors for post-hospital falls in older adults. The incidence and risk factors for post-hospital falls were extracted. The meta-analysis was used to calculate pooled incidences and 95% confidence intervals (CI). The meta-regression and subgroup meta-analysis were conducted to explore sources of heterogeneity in incidence proportions across the eligible studies. A qualitative synthesis was performed for the post-hospital falls risk factors. Results: Eighteen studies from eight countries (n = 9,080,568) were included. The pooled incidence proportion of any and recurrent post-hospital falls was 14% (95% CI: 13%-15%) and 10% (95% CI: 5%-14%), respectively. Follow-up period, study quality, study country, setting, percentage of female subjects, percentage of subjects with previous falls and the primary data collection method for falls significantly contributed to the 64.8% of the heterogeneity in incidence proportions. Twenty-six risk factors for post-hospital falls were identified in the eligible studies, where biological factors were the most commonly identified factors. The highest risks were reported for previous falls, previous fractures, delirium and neurological diseases. Conclusion: The findings of this study suggested future post-hospital falls prevention should prioritise the needs of older adults with the dominant risk factors. Further investigations into the period-specific incidence and socioeconomic and environmental risk factors for post-hospital falls are also required.
(Edited publisher abstract)
Subject terms:
falls, risk, older people, systematic reviews, literature reviews, hospital discharge;
Journal of the American Geriatrics Society, ealry cite July 2021,
Publisher:
Blackwells Publishing
Objective: To compare the effectiveness of single, multiple, and multifactorial interventions to prevent falls and fall-related fractures in community-dwelling older persons. Methods: MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were systematically searched for randomized controlled trials (RCTs) evaluating the effectiveness of fall prevention interventions exercise (risk ratio [RR] 0.83; 95% confidence interval [CI] 0.77–0.89) and quality improvement strategies (e.g., patient education) (RR 0.90; 95% CI 0.83–0.98). Exercise as a single intervention was associated with a reduction in falls rate (RR 0.79; 95% CI 0.73–0.86). Common components of multiple interventions significantly associated with a reduction in number of fallers and falls rate were exercise, assistive technology, environmental assessment and modifications, quality improvement strategies, and basic falls risk assessment (e.g., medication review). Multifactorial interventions were associated with a reduction in falls rate (RR 0.87; 95% CI 0.80–0.95), but not with a reduction in number of fallers (RR 0.95; 95% CI 0.89–1.01). The following single interventions, compared with usual care, were associated with reductions in number of fall-related fractures: basic falls risk assessment (RR 0.60; 95% CI 0.39–0.94) and exercise (RR 0.62; 95% CI 0.42–0.90). Conclusions: In keeping with Tricco et al. (2017), several single and multiple fall prevention interventions are associated with fewer falls. In addition to Tricco, we observe a benefit at the NMA-level of some single interventions on preventing
(Edited publisher abstract)
Objective: To compare the effectiveness of single, multiple, and multifactorial interventions to prevent falls and fall-related fractures in community-dwelling older persons. Methods: MEDLINE, Embase, and Cochrane Central Register of Controlled Trials were systematically searched for randomized controlled trials (RCTs) evaluating the effectiveness of fall prevention interventions in community-dwelling adults aged ≥65 years, from inception until February 27, 2019. Two large RCTs (published in 2020 after the search closed) were included in post hoc analyses. Pairwise meta-analysis and network meta-analysis (NMA) were conducted. Results: NMA including 192 studies revealed that the following single interventions, compared with usual care, were associated with reductions in number of fallers: exercise (risk ratio [RR] 0.83; 95% confidence interval [CI] 0.77–0.89) and quality improvement strategies (e.g., patient education) (RR 0.90; 95% CI 0.83–0.98). Exercise as a single intervention was associated with a reduction in falls rate (RR 0.79; 95% CI 0.73–0.86). Common components of multiple interventions significantly associated with a reduction in number of fallers and falls rate were exercise, assistive technology, environmental assessment and modifications, quality improvement strategies, and basic falls risk assessment (e.g., medication review). Multifactorial interventions were associated with a reduction in falls rate (RR 0.87; 95% CI 0.80–0.95), but not with a reduction in number of fallers (RR 0.95; 95% CI 0.89–1.01). The following single interventions, compared with usual care, were associated with reductions in number of fall-related fractures: basic falls risk assessment (RR 0.60; 95% CI 0.39–0.94) and exercise (RR 0.62; 95% CI 0.42–0.90). Conclusions: In keeping with Tricco et al. (2017), several single and multiple fall prevention interventions are associated with fewer falls. In addition to Tricco, we observe a benefit at the NMA-level of some single interventions on preventing fall-related fractures.
(Edited publisher abstract)
Subject terms:
older people, systematic reviews, falls, prevention, intervention, communities;
... and exercise needed for particular ‘at-risk’ populations. This review identified studies suggesting that for the prevention of falls in people with a falls history and/or frailer older adult, those with a high risk of fracture, those in transition to frailty with poor strength and balance, and very frail older adults.
(Edited publisher abstract)
Summarises a rapid evidence review of muscle and bone strengthening and balance activities (MBSBA) for general health benefits in adults and older adults and makes suggestions for implementation of the main findings for the public, practitioners and policy makers. The reviews highlight increasing evidence on strengthening and balance activities for general health benefits, and suggest that all adults and older adults should “undertake a programme of exercise at least twice per week that includes high intensity resistance training*, some impact exercise (running, jumping, skipping etc.) and balance training. The evidence also highlighted the variable impacts of different types of sport, physical activity or exercise. Specific consideration was given to different types of physical activities and exercise needed for particular ‘at-risk’ populations. This review identified studies suggesting that for the prevention of falls in people with a falls history and/or frailer older adult, those with a high risk of fracture, those in transition to frailty with poor strength and balance, and very frail older adults.
(Edited publisher abstract)
Subject terms:
older people, very old people, adults, sport, literature reviews, falls, prevention;
Purpose: The purpose of this paper is to provide a narrative review of what is currently known about the high rates of falls, and fall injuries, which are experienced by people with learning disabilities (LDs) throughout their lives. Design/methodology/approach: Narrative review. Current evidence is summarised as key points and recommendations for practitioners and researchers. Findings: People with LDs experience similar rates of falls as older adults in the wider population, but throughout their lives, or at an earlier age. Originality/value: Key points and recommendations are summarised for practitioners and researchers to promote fall prevention strategies and interventions for people with LDs.
(Edited publisher abstract)
Purpose: The purpose of this paper is to provide a narrative review of what is currently known about the high rates of falls, and fall injuries, which are experienced by people with learning disabilities (LDs) throughout their lives. Design/methodology/approach: Narrative review. Current evidence is summarised as key points and recommendations for practitioners and researchers. Findings: People with LDs experience similar rates of falls as older adults in the wider population, but throughout their lives, or at an earlier age. Originality/value: Key points and recommendations are summarised for practitioners and researchers to promote fall prevention strategies and interventions for people with LDs.
(Edited publisher abstract)
Subject terms:
falls, prevention, learning disabilities, health education, risk assessment, injuries, epilepsy;