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World guidelines for falls prevention and management for older adults: a global initiative

Montero-Odasso M 1 , van der Velde N 2 , Martin FC 3 , Petrovic M 4 , Tan MP 5 , Ryg J 6 Show all authors , Aguilar-Navarro S 7 , Alexander NB 8 , Becker C 9 , Blain H 10 , Bourke R 11 , Cameron ID 12 , Camicioli R 13 , Clemson L 14 , Close J 15 , Delbaere K 16 , Duan L 17 , Duque G 18 , Dyer SM 19 , Freiberger E 20 , Ganz DA 21 , Gómez F 22 , Hausdorff JM 23 , Hogan DB 24 , Hunter SMW 25 , Jauregui JR 26 , Kamkar N 1 , Kenny RA 11 , Lamb SE 27 , Latham NK 28 , Lipsitz LA 29 , Liu-Ambrose T 30 , Logan P 31 , Lord SR 32 , Mallet L 33 , Marsh D 34 , Milisen K 35 , Moctezuma-Gallegos R 36 , Morris ME 37 , Nieuwboer A 38 , Perracini MR 39 , Pieruccini-Faria F 1 , Pighills A 40 , Said C 41 , Sejdic E 42 , Sherrington C 43 , Skelton DA 44 , Dsouza S 45 , Speechley M 46 , Stark S 47 , Todd C 48 , Troen BR 49 , van der Cammen T 50 , Verghese J 51 , Vlaeyen E 35 , Watt JA 52 , Masud T 53 , Task Force on Global Guidelines for Falls in Older Adults

Affiliations 

  • 1 Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute, London, ON, Canada
  • 2 Amsterdam UMC location University of Amsterdam, Internal Medicine, Section of Geriatric Medicine, Amsterdam, The Netherlands
  • 3 Population Health Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
  • 4 Department of Internal Medicine and Paediatrics, Section of Geriatrics, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
  • 5 Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia
  • 6 Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
  • 7 Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
  • 8 Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan; Veterans Administration Ann Arbor Healthcare System Geriatrics Research Education Clinical Center, Ann Arbor, MI, USA
  • 9 Department of Clinical Gerontology and Geriatric Rehabilitation, Robert Bosch Hospital, Stuttgart, Germany
  • 10 Department of Geriatrics, Montpellier University hospital and MUSE, Montpellier, France
  • 11 Department of Medical Gerontology Trinity College Dublin and Mercers Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
  • 12 John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District and Faculty of Medicine and Health, University of Sydney. Department of Medicine (Neurology) and Neuroscience and Mental Health, Sydney, NSW, Australia
  • 13 Department of Medicine (Neurology), Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
  • 14 Sydney School of Health Sciences, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
  • 15 Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney, NSW, Australia
  • 16 Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia; School of Population Health, University of New South Wales, Kensington, NSW, Australia
  • 17 National Centre for Chronic and Noncommunicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing, China
  • 18 Research Institute of the McGill University HealthCentre, Montreal, Quebec, Canada
  • 19 Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA, Australia
  • 20 Friedrich-Alexander-University Erlangen-Nürnberg, Institute for Biomedicine of Aging, Nürnberg, Germany
  • 21 Multicampus Program in Geriatric Medicine and Gerontology, David Geffen School of Medicine at UCLA and Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
  • 22 Research Group on Geriatrics and Gerontology, International Association of Gerontology and Geriatrics Collaborative Center, University Caldas, Manizales, Colombia
  • 23 Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
  • 24 Brenda Strafford Centre on Aging, O'BrienInstitute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
  • 25 School of Physical Therapy, Faculty of Health Sciences, Elborn College, University of Western Ontario, London, ON, Canada
  • 26 Ageing Biology Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
  • 27 Faculty of Health and Life Sciences, Mireille Gillings Professor of Health Innovation, Medical School Building, Exeter, England, UK
  • 28 Brigham and Women's Hospital, Boston, MA, USA
  • 29 Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
  • 30 Djavad Mowafaghian Centre for Brain Health, Center for Hip Health and Mobility, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
  • 31 School of Medicine, University of Nottingham, Nottingham, England, UK
  • 32 Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia
  • 33 Department of Pharmacy, Faculty of Pharmacy, McGill University Health Center, Université de Montréal, Montreal, QC, Canada
  • 34 University College London, London, England, UK
  • 35 Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
  • 36 Geriatric Medicine & Neurology Fellowship, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán". Mexico City, Mexico
  • 37 Healthscope and Academic and Research Collaborative in Health (ARCH), La Trobe University, Australia
  • 38 Department of Rehabilitation Sciences, Neurorehabilitation Research Group (eNRGy), KU Leuven, Leuven, Belgium
  • 39 Master's and Doctoral programs in Physical Therapy, Universidade Cidade de Sao Paulo (UNICID), Sao Paulo, Brazil
  • 40 Mackay Institute of Research and Innovation, Mackay Hospital and Health Service, Mackay, QLD, Australia
  • 41 Western Health, University of Melbourne, Parkville, Melbourne, VIC, Australia
  • 42 Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
  • 43 Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
  • 44 School of Health and Life Sciences, Research Centre for Health (ReaCH), Glasgow Caledonian University, Cowcaddens Road, Glasgow, Scotland, UK
  • 45 Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
  • 46 Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
  • 47 Program in Occupational Therapy, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
  • 48 School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, England, UK
  • 49 Division of Geriatrics and Palliative Medicine, Department of Medicine, Jacobs School of Medicine & Biomedical Sciences, University of Buffalo; Research Service, Veterans Affairs Western New York Healthcare System, Buffalo, New York, USA
  • 50 Department of Human-Centred Design, Faculty of Industrial Design Engineering, Delft University of Technology, Delft, The Netherlands
  • 51 Division of Geriatrics, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
  • 52 Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
  • 53 Department of Geriatric Medicine, The British Geriatrics Society, Nottingham University Hospitals NHS Trust, Nottingham, England, UK
Age Ageing, 2022 Sep 02;51(9).
PMID: 36178003 DOI: 10.1093/ageing/afac205

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.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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