The  US Preventive Services Task Force (USPSTF) recently published a systematic review that evaluated the effectiveness and harms of interventions to prevent falls and fall-related morbidity and mortality in community-dwelling adults 65 years or older.

The USPSTF concluded that exercise interventions provide a moderate net benefit in preventing falls and fall-related morbidity in older adults at increased risk for falls, and that multifactorial interventions provide a small net benefit. Multifactorial interventions could include psychological interventions such as cognitive behavioral therapy; nutrition therapy; and environmental modification.

Overall, the USPSTF recommendation is that exercise interventions should be offered to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls.

Furthermore, clinicians should individualize the decision to offer multifactorial interventions to prevent falls in this population, because the evidence indicates that the overall net benefit of routinely offering such interventions to prevent falls is small.

When determining whether these interventions are appropriate for an individual, the balance of benefits and harms based on the circumstances of prior falls, presence of comorbid medical conditions, and the individual’s values and preferences should be considered.

Based on the noninvasive nature of most of the interventions, USPSTF suggests that the likelihood of serious harms is low, and studies suggest that the risk of harms is small.

The USPSTF also points to recommendations from other health agencies, as follows: The US Centers for Disease Control and Prevention recommends STEADI, a coordinated approach for fall prevention in adults 65 years or older that consists of 3 core elements: screen to identify fall risk, assess modifiable risk factors, and intervene using effective clinical and community strategies to reduce the identified risk.

The US Department of Health and Human Services recommends that older adults engage in multicomponent physical activity that includes balance training, as well as aerobic and muscle-strengthening activities, as part of the 150 to 300 minutes per week of moderate-intensity, or 75 to 150 minutes per week of vigorous-intensity aerobic physical activity recommended for all adults. 

The American Academy of Family Physicians supports the USPSTF 2018 recommendation on fall prevention in community-dwelling older adults.

To read the full USPSTF recommendation, click here

To download a pdf of the full recommendation, click here