Journal of rehabilitation research and development
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The objective of this study was to summarize the evidence on the accuracy of screening tools for predicting falling risk in community-living older adults. This study was designed as a systematic review. Prospective studies of clinical fall risk prediction tools that provided data on the number of participants who sustained falls during follow-up were included. ⋯ Most tools discriminated poorly between fallers and nonfallers. We found that existing studies are methodologically variable and the results are inconsistent. Insufficient evidence exists that any screening instrument is adequate for predicting falls.
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The incidence of falls, fall-related injuries, and fall-associated costs continue to rise along with the increase in the aging population. Community-based fall prevention programs for the elderly are proliferating in an attempt to address this health problem. ⋯ This article presents a review of randomized controlled trials that investigated the effectiveness of fall prevention programs for community-dwelling older adults. Following a comprehensive critical analysis of the literature, we present the following guidelines: (1) multifactorial fall prevention programs appear to be more effective for older individuals with a previous fall history versus a nonselect group; (2) medication and vision assessment with appropriate health practitioner referral should be included in a falls screening examination; (3) exercise alone is effective in reducing falls and should include a comprehensive program combining muscle strengthening, balance, and/or endurance training for a minimum of 12 weeks; and (4) home hazard assessment with modifications may be beneficial in reducing falls, especially in a targeted group of individuals.