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Journal of Aging and Health
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Article

Environmental Interventions to Prevent Falls in Community-Dwelling Older People: A Meta-Analysis of Randomized Trials

Lindy Clemson, PhD*, Lynette Mackenzie, PhD, Claire Ballinger, PhD, Jacqueline C. T. Close, MD, and Robert G. Cumming, PhD

* To whom correspondence should be addressed. E-mail: l.clemson{at}usyd.edu.au.


  Abstract
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.

First published on September 24, 2008, doi:10.1177/0898264308324672

Journal of Aging and Health 2008;20:954.

A more recent version of this article appeared on December 1, 2008

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This article has been cited by other articles:


Home page
 J Aging HealthHome page
B. A. Steinman, J. Pynoos, and A. Q. D. Nguyen
Fall Risk in Older Adults: Roles of Self-Rated Vision, Home Modifications, and Limb Function
J Aging Health, August 1, 2009; 21(5): 655 - 676.
[Abstract] [PDF]