104 clinical trials reveal best ways to prevent aged care falls

A Flinders University-led international review has analysed data from 104 aged care facility clinical trials to reveal the best ways to prevent falls. The trials involved almost 69,000 older people living in care facilities across 25 countries and showed tailored exercise programs, vitamin D supplements and better nutrition to be the proven paths to falls prevention. The study, lead author Dr Suzanne Dyer said, is the most comprehensive of its kind and offers clear guidance for aged care providers, policymakers and families.

Dr Suzanne Dyer. Source: Flinders University

“Falls are one of the most common and serious health risks facing older Australians; they can lead to broken bones, hospital stays and a loss of independence,” said Dyer, from Flinders Health and Medical Research Institute (FHMRI). “Our findings show that preventing falls isn’t about a one-size-fits-all solution but there are some simple, easily deployed and targeted ways to make a real difference in reducing falls,” said Dr Jenni Suen, another author of the review — also from FHMRI.

Dr Jenni Suen. Source: Flinders University

Approaches tailored to each resident’s needs and delivered with strong support from aged care staff were found by the review to be the most effective in preventing falls in residential aged care — with exercise and nutrition being common themes. “One of the most effective strategies was regular, supervised exercise, which reduced falls even in residents with cognitive impairments, like dementia,” Suen said. “We found that this type of exercise, especially when done consistently, and in groups or for more than an hour a week, were shown to reduce the number of falls.”

The addition of vitamin D supplements has also proved helpful in reducing the overall number of falls, the researchers found — with many older Australians in care having low vitamin D levels, which can affect muscle strength. To strengthen bones with the result being fewer falls and fractures, nutrition was shown to also play a role — with an increase in dairy servings that were high in calcium. “By adding more calcium and protein-rich foods like milk, cheese and yoghurt, aged care homes were able to improve residents’ bone health and stability,” Dyer said.

Giving each resident an environmental assessment, medication review and an exercise plan based on their individual needs — delivered with strong staff engagement — was also shown by the review to significantly reduce falls. “As part of our research, we wanted to see what types of programs weren’t working as effectively in preventing falls,” Dyer said. “Programs such as improving medication use (deprescribing or reviewing prescriptions) and staff training, and changes to care models on their own didn’t consistently reduce falls,” Dyer added. “We now have strong evidence that some approaches work better than others.”

Dyer concluded: “Tailored exercise programs, vitamin D supplements and better nutrition can make a real difference. With the right mix of strategies, it’s possible to reduce risks and help older people in care stay safer and more independent.” The review was published open access in August — in Cochrane Database of Systematic reviews — and you can read it at doi.org/10.1002/14651858.CD016064.

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