The rate of falls in older adults could be slashed by 26% overall, and 38% for those most at risk, if living space hazards are eliminated, according to a new Cochrane review.
Approximately one‐third of people aged 65 years and older fall each year, and more than 30% of all falls are a result of environmental hazards, the authors reported. To quantify the estimated effect of hazard assessment and intervention on falls risk in that age group, Lindy Clemson, of University of Sydney, Australia and colleagues analyzed 22 studies, including data on more than 8,400 community-dwelling older adults.
The research showed that older adults at high risk of falling benefitted from being aware of the fall hazards in their living environment, reducing these hazards and adapting to risk by practicing safe behaviors.
Contributions to risk
In-home problems that contributed to falls risk included slippery floor mats, poor lighting, clutter and lack of stair railings, among similar issues. The authors’ recommendations included fixes such as adding handrails and non-slip strips to steps, for example.
Based on the findings, if 1,000 people with a prior fall followed hazard-reduction measures for about a year, total falls would be cut from 1,847 to 1,145, the authors estimated.
OT support advantage
It was also evident that it takes more than a checklist of hazards to make a difference in reducing risk, according to Clemson. Professional support from an occupational therapist who can provide a full assessment of the level of risk and the living environment may be necessary, she said.
“Having had a fall or starting to need help with everyday activities are markers of underlying risk factors, such as being unsteady on your feet, having poor judgment or weak muscles,” Clemson said in a statement. Older people may not notice changes to their mobility and balance, and may not recognize the hazards around them, she said.
“These risk factors make negotiating the environment more challenging and increase the risk of a trip or slip in some situations,” she added.
Need for more data
Notably, the review did not find evidence that measures such as correcting prescription glasses, special footwear, bed alarm systems or education was helpful. Research is lacking on how providing equipment or modifications to daily living activities such as showering or cooking impacts risk, the authors reported.
“Preventing falls is a really important way of helping people to remain healthy and independent as they grow older, and our review also highlights the need for more research in this area,” Clemson concluded.
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