title: Effectiveness of Non-Pharmacological Interventions to Prevent Falls in Older People: A Systematic Overview. The SENATOR Project ONTOP Series.
abstract: BACKGROUND
  Falls are common events in older people, which cause considerable morbidity and mortality. Non-pharmacological interventions are an important approach to prevent falls. There are a large number of systematic reviews of non-pharmacological interventions, whose evidence needs to be synthesized in order to facilitate evidence-based clinical decision making.
  
  
  OBJECTIVE
  To systematically examine reviews and meta-analyses that evaluated non-pharmacological interventions to prevent falls in older adults in the community, care facilities and hospitals.
  
  
  METHODS
  We searched the electronic databases Pubmed, the Cochrane Database of Systematic Reviews, EMBASE, CINAHL, PsycINFO, PEDRO and TRIP from January 2009 to March 2015, for systematic reviews that included at least one comparative study, evaluating any non-pharmacological intervention, to prevent falls amongst older adults. The quality of the reviews was assessed using AMSTAR and ProFaNE taxonomy was used to organize the interventions.
  
  
  RESULTS
  Fifty-nine systematic reviews were identified which consisted of single, multiple and multifactorial non-pharmacological interventions to prevent falls in older people. The most frequent ProFaNE defined interventions were exercises either alone or combined with other interventions, followed by environment/assistive technology interventions comprising environmental modifications, assistive and protective aids, staff education and vision assessment/correction. Knowledge was the third principle class of interventions as patient education. Exercise and multifactorial interventions were the most effective treatments to reduce falls in older adults, although not all types of exercise were equally effective in all subjects and in all settings. Effective exercise programs combined balance and strength training. Reviews with a higher AMSTAR score were more likely to contain more primary studies, to be updated and to perform meta-analysis.
  
  
  CONCLUSIONS
  The aim of this overview of reviews of non-pharmacological interventions to prevent falls in older people in different settings, is to support clinicians and other healthcare workers with clinical decision-making by providing a comprehensive perspective of findings.
authors: Geriatrics and Geriatric Emergency Care, Italian National Research Center on Aging, Ancona, Italy.
authors: Joseph M
authors: JM
authors: Rimland
authors: Geriatrics and Geriatric Emergency Care, Italian National Research Center on Aging, Ancona, Italy.
authors: Iosief
authors: I
authors: Abraha
authors: Geriatrics and Geriatric Emergency Care, Italian National Research Center on Aging, Ancona, Italy.
authors: Giuseppina
authors: G
authors: Dell'Aquila
authors: Division of Geriatrics, Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors: Alfonso
authors: A
authors: Cruz-Jentoft
authors: Department of Medicine for the Elderly, Woodend Hospital, Aberdeen, United Kingdom.
authors: Roy
authors: R
authors: Soiza
authors: Landspitali University Hospital Reykjavik, Reykjavik, Iceland.
authors: Adalsteinn
authors: A
authors: Gudmusson
authors: Ghent University Hospital, Ghent, Belgium.
authors: Mirko
authors: M
authors: Petrovic
authors: Division of Geriatrics, Department of Medicine, University College Cork, Cork, Ireland.
authors: Denis
authors: D
authors: O'Mahony
authors: School of Health Sciences, The University of Manchester, Manchester, United Kingdom.
authors: Chris
authors: C
authors: Todd
authors: Geriatrics and Geriatric Emergency Care, Italian National Research Center on Aging, Ancona, Italy.
authors: Antonio
authors: A
authors: Cherubini
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D000066491:Clinical Decision-Making; D020000:Decision Support Systems, Clinical; D019317:Evidence-Based Medicine; D015444:Exercise; D005081:Exercise Therapy; D006761:Hospitals; D006801:Humans; D057187:Independent Living; D009735:Nursing Homes; D016896:Treatment Outcome