World guidelines for falls prevention and management for older adults
a global initiative
Manuel Montero-Odasso (University of Western Ontario, Lawson Health Research Institute)
Nathalie van der Velde (Amsterdam Public Health, Amsterdam UMC)
Finbarr C. Martin (King’s College London)
Mirko Petrovic (Universiteit Gent)
Maw Pin Tan (University of Malaya)
Jesper Ryg (Odense University Hospital, University of Southern Denmark)
Tischa J.M. van der Cammen (TU Delft - Human Factors, Erasmus MC)
W. Song (TU Delft - Emerging Materials)
Anton Jellema (TU Delft - Human Factors)
G.B. More authors (External organisation)
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Abstract
BACKGROUND: falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. Current guidelines are inconsistent, with no up-to-date, globally applicable ones present. OBJECTIVES: to create a set of evidence- and expert consensus-based falls prevention and management recommendations applicable to older adults for use by healthcare and other professionals that consider: (i) a person-centred approach that includes the perspectives of older adults with lived experience, caregivers and other stakeholders; (ii) gaps in previous guidelines; (iii) recent developments in e-health and (iv) implementation across locations with limited access to resources such as low- and middle-income countries. METHODS: a steering committee and a worldwide multidisciplinary group of experts and stakeholders, including older adults, were assembled. Geriatrics and gerontological societies were represented. Using a modified Delphi process, recommendations from 11 topic-specific working groups (WGs), 10 ad-hoc WGs and a WG dealing with the perspectives of older adults were reviewed and refined. The final recommendations were determined by voting. RECOMMENDATIONS: all older adults should be advised on falls prevention and physical activity. Opportunistic case finding for falls risk is recommended for community-dwelling older adults. Those considered at high risk should be offered a comprehensive multifactorial falls risk assessment with a view to co-design and implement personalised multidomain interventions. Other recommendations cover details of assessment and intervention components and combinations, and recommendations for specific settings and populations. CONCLUSIONS: the core set of recommendations provided will require flexible implementation strategies that consider both local context and resources.
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