title: Environmental interventions to prevent falls in community-dwelling older people: a meta-analysis of randomized trials.
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.
authors.affiliation: University of Sydney.
authors.forename: Lindy
authors.initials: L
authors.lastname: Clemson
authors.forename: Lynette
authors.initials: L
authors.lastname: Mackenzie
authors.forename: Claire
authors.initials: C
authors.lastname: Ballinger
authors.forename: Jacqueline C T
authors.initials: JC
authors.lastname: Close
authors.forename: Robert G
authors.initials: RG
authors.lastname: Cumming
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000061:Accidents, Home / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D004777:Environment; D016852:Housing for the Elderly; D006801:Humans; D016032:Randomized Controlled Trials as Topic