USPSTF releases draft recommendations on fall prevention among the elderly

The U.S. Preventive Services Task Force has issued several draft recommendations on various interventions to prevent falls in adults who are aged 65 years and older, live at home and are at increased risk for falls.

Specifically, the task force gave a ‘B’ recommendation to exercise.

“Falls can cause significant injuries in older adults, so preventing falls is important to maintaining their physical well-being. We found that exercise can help prevent falls,” Alex Krist, MD, MPH, task force member, clinician, and professor of family medicine and population health at Virginia Commonwealth University,” said in a press release.

In addition, the task force also gave a ‘D’ recommendation against vitamin D supplementation; and a ‘C’ recommendation on selectively offering multifactorial interventions for the prevention of falls.

“When determining whether this service is appropriate for an individual, patients and clinicians should consider the balance of benefits and harms based on the circumstances of prior falls, presence of comorbid medical conditions, and the patient’s values and preferences,” the task force wrote regarding its recommendation on multifactorial interventions.

The draft recommendation statements are based on evidence gleaned from 62 studies.

Results revealed that roughly 2.8 million older adults sought treatment in emergency departments for falls in 2014; approximately 800,000 older adults experiencing a fall were hospitalized; and more than 27,000 older adults died from a fall, the task force stated. In addition, the risk for falls increases with age, with more than one in four adults aged 65 to 74 years reporting a fall in 2014 compared with more than one in three adults aged 85 years or older, according to task force members.

“The burden of falls on patients and the health care system is large. Reducing the incidence of falls would also improve the socialization and functioning of older adults who have previously fallen and fear falling again,” the task force members wrote. “Many other interventions could potentially be useful to prevent falls, but because of the heterogeneity in the target patient population, heterogeneity ... of predisposing factors, and their additive or synergistic nature, the effectiveness of other interventions is not known. However, many interventions with insufficient evidence to support their use to prevent falls have other arguments that support their use.”

The task force members stated that research gaps exist regarding the clinical validation of primary care tools in classifying older adults at increased risk for falls.

“More efficacy trials are needed on how the following interventions may help prevent falls if offered alone and not as part of multifactorial interventions: environmental modification, medication management and psychological interventions,” they also wrote.

The USPSTF draft statement and evidence review is available for public comment through Oct. 23, 2017, at: www.uspreventiveservicestaskforce.org. - by Janel Miller

Disclosure: Healio Family Medicine was unable to confirm authors’ relevant financial disclosures at the time to publication.