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What Works Better for Community-Dwelling Older People at Risk to Fall?

A Meta-Analysis of Multifactorial Versus Physical Exercise-Alone Interventions

University of Athens Medical School, Goudi, Greece, epetrid{at}med.uoa.gr

Eirini G. Manti, MPhil

University of Athens Medical School, Goudi, Greece

Athanasios G. Ntinapogias, BSc

University of Athens Medical School, Goudi, Greece

Eva Negri, ScD

Istituto di Ricerche Farmacologiche "Mario Negri," Milan, Italy

Katarzyna Szczerbiska, MD, PhD

Institute of Public Health, Jagiellonian University Medical College, Kraków, Poland

Objective: To compare and quantify the effectiveness of multifactorial versus exercise-alone interventions in reducing recurrent falls among community-dwelling older people. Method : A meta-analysis of recently published studies on fall prevention interventions was conducted. Measure of the overall effectiveness was the combined risk ratio for recurrent falls, whereas heterogeneity was explored via metaregression analyses. Results: Ten of the 52 identified studies met the preset criteria and were included in the analysis. The exercise-alone interventions were about 5 times more effective compared to multifactorial ones. Short-term interventions, smaller samples, and younger age related to better outcomes. Discussion: From cost-efficiency and public health perspectives, exercise-alone interventions can be considered valuable, as they are more likely to be implemented in countries with less resources. Further qualitative research is needed, however, to explore determinants of willingness to participate and comply with interventions aiming to prevent recurrent falls among older people.

Key Words: recurrent fall prevention interventions • community-dwelling older people at risk • physical exercise • meta-analysis • compliance

This version was published on August 1, 2009

Journal of Aging and Health, Vol. 21, No. 5, 713-729 (2009)
DOI: 10.1177/0898264309338298


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