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

Abstract

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.

Keywords

Affiliated Institutions

• University of Southern Denmark DK
• Parkwood Institute CA
• The University of Melbourne AU
• National Center for Chronic and Noncommunicable Disease Control and Prevention CN
• Glasgow Caledonian University GB
• Trinity College Dublin IE
• University of Manchester GB
• King's College London GB
• Australian Institute for Musculoskeletal Science AU
• VA Greater Los Angeles Healthcare System US
• Tel Aviv Sourasky Medical Center IL
• University College London GB
• Hasselt University BE
• St. James's Hospital IE
• Tecnológico de Monterrey MX
• University of Toronto CA
• Amsterdam University Medical Centers NL
• Lawson Health Research Institute CA
• La Trobe University AU
• Melbourne Health AU
• VA Western New York Healthcare System US
• Université de Montpellier FR
• Flinders University AU
• Delft University of Technology NL
• University of Amsterdam NL
• UNSW Sydney AU
• Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán MX
• Universidade Cidade de São Paulo BR
• Northern Sydney Local Health District AU
• Rush University Medical Center US
• Nottingham University Hospitals NHS Trust GB
• Manchester University NHS Foundation Trust GB
• Friedrich-Alexander-Universität Erlangen-Nürnberg DE
• Jacobs (United States) US
• Robert Bosch Hospital DE
• Université de Montréal CA
• GGD Amsterdam NL
• McGill University CA
• Albert Einstein College of Medicine US
• The University of Sydney AU
• Hospital Italiano de Buenos Aires AR
• VA Ann Arbor Healthcare System US
• Hebrew SeniorLife US
• University of Malaya MY
• Western University CA
• Odense University Hospital DK
• Brigham and Women's Hospital US
• KU Leuven BE
• Institute for Musculoskeletal Health AU
• St. Michael's Hospital CA
• Vancouver Coastal Health CA
• University at Buffalo, State University of New York US
• Western Health AU
• British Geriatrics Society GB
• Manchester Academic Health Science Centre GB
• Sydney Local Health District AU
• McGill University Health Centre CA
• University of British Columbia CA
• Vancouver Coastal Health Research Institute CA
• Centre Hospitalier Universitaire de Montpellier FR
• Mackay Base Hospital AU
• Manipal Academy of Higher Education IN
• Erasmus MC NL
• University of Nottingham GB
• Ghent University BE
• Tel Aviv University IL
• University of Pittsburgh US
• Beth Israel Deaconess Medical Center US
• University of Michigan US
• Women and Children’s Health Research Institute CA
• University of Calgary CA
• Washington University in St. Louis US
• Neuroscience Research Australia AU
• University of Alberta CA

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