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Single-factor Interventions
Home Assessment:
When olderpatients at elevated risk of falls are discharged from the hospital, an environmental home assessment should be considered.The use of antidepressants, sedatives, hypnotics, and benzodiazepines demonstrates a significant correlation to falls in older people.Studies demonstrate that home visits by occupational therapists can be instrumental in preventing falls among older people who are at an increased risk of falling.[13][14]
Exercise Programs:
Exercise programs help prevent falls with no differences between types of exercise interventions, including endurance, platform balance, tai chi, resistance, and flexibility.[15]
Tai chi is a time-honored martial art that involves slow, rhythmic movements, including rotation of the trunk, shifting weight, coordination, and a gradual progression to narrowing the lower extremity stance.Patients with a history of fractures are unfortunately not candidates for participation in tai chi.[16]
Balance focused exercises, specifically (1) walking heel to toe, and (2) standing on one foot, in combination with coordination exercises, are also proposed for fall prevention.[17]
Medication Review:
Several common medications have been implicated as important contributors to the risk of falling in older adults.In medicines that could be attributed to causing falls, the risks and benefits of continuance must be carefully evaluated, and any unnecessary medications should be discontinued.[18]
Vitamin D Supplementation:
Vitamin D has benefits for improved muscle strength and balance.It also offers multiple musculoskeletal and cardiopulmonary benefits.
Single-factor Interventions
Home Assessment:
When olderpatients at elevated risk of falls are discharged from the hospital, an environmental home assessment should be considered. Studies demonstrate that home visits by occupational therapists can be instrumental in preventing falls among older people who are at an increased risk of falling.[13][14]
Exercise Programs:
Exercise programs help prevent falls with no differences between types of exercise interventions, including endurance, platform balance, tai chi, resistance, and flexibility.[15]
Tai chi is a time-honored martial art that involves slow, rhythmic movements, including rotation of the trunk, shifting weight, coordination, and a gradual progression to narrowing the lower extremity stance. It has gained recognition as a good exercise choice for the older individuals. Studies have shown tai chi improves postural stability more so than other exercises. It also offers multiple musculoskeletal and cardiopulmonary benefits. Patients with a history of fractures are unfortunately not candidates for participation in tai chi.[16]
Balance focused exercises, specifically (1) walking heel to toe, and (2) standing on one foot, in combination with coordination exercises, are also proposed for fall prevention.[17]
Medication Review:
Several common medications have been implicated as important contributors to the risk of falling in older adults. All medications should be reviewed in patients with falls. Particular attention should be paid to patients who receive four or more medications and to those taking psychotropic medications, as these medications have specifically been linked to a strong chance of a future fall. The use of antidepressants, sedatives, hypnotics, and benzodiazepines demonstrates a significant correlation to falls in older people. Side effects of specific medications and interactions between medications are a potential reason for falls in older adults. In medicines that could be attributed to causing falls, the risks and benefits of continuance must be carefully evaluated, and any unnecessary medications should be discontinued.[18]
Vitamin D Supplementation:
Vitamin D has benefits for improved muscle strength and balance. For community-dwelling or long term care residents, vitamin D supplementation in doses from 700 IU/d to 1000 IU/d can reduce falls by 19% after 2-5 months of starting treatment.[19]
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