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Journal of Aging and Health
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What's this?

Environmental Interventions to Prevent Falls in Community-Dwelling Older People

A Meta-Analysis of Randomized Trials

Lindy Clemson, PhD

University of Sydney

Lynette Mackenzie, PhD

University of Sydney

Claire Ballinger, PhD

Glasgow Caledonian University

Jacqueline C. T. Close, MD

University of New South Wales, Sydney

Robert G. Cumming, PhD

University of Sydney

Objective: This study seeks to determine the efficacy of environmental interventions in reducing falls in community-dwelling older people. Method: A systematic review and meta-analysis of randomized trials was performed. Results: Pooled analysis of six trials (N = 3,298) demonstrated a 21% reduction in falls risk (relative risk [RR] = 0.79; 0.65 to 0.97). Heterogeneity was attributable to the large treatment effect of one trial. Analysis of a subgroup of studies with participants at high risk of falls (four trials, n = 570) demonstrated a clinically significant 39% reduction of falls (RR = 0.61; 0.47 to 0.79), an absolute risk difference of 26% for a number needed to treat four people. Discussion: Home assessment interventions that are comprehensive, are well focused, and incorporate an environmental-fit perspective with adequate follow-up can be successful in reducing falls with significant effects. The highest effects are associated with interventions that are conducted with high-risk groups.

Key Words: accidental falls • home visits • home assessment • occupational therapy • systematic review

This version was published on December 1, 2008

Journal of Aging and Health, Vol. 20, No. 8, 954-971 (2008)
DOI: 10.1177/0898264308324672
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