State of Science: Falls Prevention. Program. In Community-Dwelling Elders
Keywords:
accidental falls, risks of falls, falls prevention program, community-dwelling elders, fall-related injuryAbstract
Background: For older adults, numerous age-related changes, functional impairments, and risk factors contribute to a high incidence of falls. The phenomenon of falls in community-dwelling elders is a significant global health care problem because of its high potential of increasing morbidity, mortality, reduced functioning or disability. Falls can lead to premature nursing home admissions, hospitalization, psychological and social consequences, and financial burden for individuals and health care systems across the world.
Objective: The objective of this study was to describe the state of the science of prevalence fall risk factors, the effects of falls on the elders, and fall prevention programs for elders in Thailand as well as other countries.
Materials and Methods: The search strategy was based on electronic searches including CINHAL (OVID ONLINE), the Cochrane Library, handsearch of selected journals, and snowballing from reference lists of selected publications during January 2000 until December 2005. The search terms were accidental falls, risks of falls, falls prevention program, community-dwelling elders, and fall-related injury.
Results: The most salient risk factor of fall in community-dwelling elders both in Thailand and in other countries is the impairment of gait and balance. A fall prevention program for the community-dwelling elders should combine strategies including fall prevention education sessions and Tai Chi exercise sessions. These interventions would include physical modification, behavioral modification, and improved environmental safety.
Conclusions: Research about the effects of a fall prevention program for the Thai community-dwelling elders should be aimed at improving their gait and balance. An effective fall prevention program is one critical way to enhance the quality of life for the elders in Thailand as well as worldwide.
References
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4. Rubenstein LZ, Powers CM, MacLean CH. Quality Indicators for the Management and Prevention of Falls and Mobility Problems in Vulnerable Elders. Ann Intern Med 2001;135:686-93.
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10. Lausawatchaikul P, Factors and the Consequences of Falls in the elderly. A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Nursing Science. Faculty of Graduate Studies, Mahidol University, Bangkok, Thailand, 2000.
11. Fleming BE, Pendergast DR. Physical condition, activity pattern, and environment as factors in falls by adult care facility residents. Arch Phys Med Rehabil 1993; 74: 627-30.
12. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the Prevention of Falls in Older Persons. JAGS 2001;49:664-72.
13. Nuffield Institute for Health, University of Leeds and NHS Center for Reviews and Disseminations. Prevention and subsequent injury in older people. Effective Healthcare 1996;2:1-16.
14. Rubenstein LZ, Josephson KR. The epidemiology of falls and syncope. Clin Geriatr Med 2002;18:141-58.
15.Jitmontri N, Phasynun N, Ronritthiwichai J. The House Environment that Caused the Fall-accident to the Elderly. J NURS (Mahidol Univ) 1998: 16: 34-45.
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17. Berg K, Wood-Dauphinee S, Williams JI, Maki B, Measuring balance in the elderly: validation of an instrument. Can J Publ Health 1992:2 (Suppl):304-11.
18. Nelson RC, Amin MA, Falls in elderly, Emerg Med Clin North Am 1990;8:309-24.
19. Tinetti ME, Doucette J, Claus E, Marottoli R. Risk factors for serious injury during falls by older persons in the community. J Am Geriatr Soc 1995;43:1214-21.
20. Roach ss. Introductory gerontological nursing. Philadelphia: Lippincott; 2001.
21. Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. Am J Publ Health 1992;82:1020-3.
22. Schoenfelder DP, Crowell CM. From Risk for Trauma to Unintentional Injury Risk: Falls - A Concept Analysis. Nursing Diagnosis 1999;10:149-57.
23. Kosorok MR, Omenn GS, Diehr P, Koepsell TD, Patrick DL. Restricted activity days among older adults. Am J Publ Health 1992;82:1263-7.
24. Rubenstein LZ, Josephson KR, Robbins AS. Falls in the nursing home. Ann Intern Med 1994;121:442-51.
25. Rubenstein LZ, Powers CM, MacLean CH. Quality Indicators for the Management and Prevention of Falls and Mobility Problems in Vulnerable Elders. Ann Intern Med 2001;135:686-93.
26. Brown AP. Reducing falls in elderly people: A review of exercise interventions. Physiother Theory Pract 1999;15:59-68.
27. Maki BE, Holliday PJ, Topper AK. Fear of falling and postural performance in the elderly. J Gerontol 1991;46:M 123-131.
28. Arfken CL, Lach HW, Birge SJ, Miller JP. The prevalence and correlates of fear of falling in elderly persons living in the community. Am J Public Health 1994;84:565-70.
29. Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH. Interventions for preventing falls in elderly people (Cochrane Review). The Cochrane Library 2004: Issue 1.
30. Hill-Westmoreland EE, Soeken K, Spelibring AM. A meta-analysis of fall prevention programs for the elderly: how effective are they? Nursing Research 2002;51:1-8.
31. Robertson MC, Campbell AJ, Gardner MM, Devlin N. Preventing injuries in older people by preventing falls: a meta-analysis of individual-level data. J Am Geriatr Soc 2002;50:905-11.
32. Weatherall M. Preventing of falls and fall-related fracture in community- dwelling older adults: a meta-analysis of estimates of effectiveness based on recent guidelines. Intern Med 2004;34:102-8,
33. Chang JT, Morton SC, Rubenstein LZ, et al. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. Br Med J 2004; 328:680-3.
34. Gardner MM, Robertson CM, Campbell JA. Exercise in preventing falls and fall related injuries in older people; a review of randomized controlled trials. Br J Sports Med 2000;34:7-17.
35. Fiatarone MA, O'Neill EF, Ryan ND, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Eng J Med 1994;330:1769-75.
36. Province MA, Hadley EC, Hornbrook MC, et al. The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials Frailty and Injuries: Cooperative Studies of Intervention Techniques. JAMA 1995;273:1341-7.
37. Wolf SL, Barnhart HX, Kutner NG, McNeely E, Coogler C, Xu T. Deducing frailty and falls in older persons: an investigation of Tai Chi and computerised balance training. Atlanta FICSIT Group. Frailty and injuries; cooperative studies of intervention
techniques. J Am Geriatric Soc 1996;44:489-97.
38. Li F, Harmer P, Fisher KJ, Mcauley E. Tai Chiะ improving functional balance and predicting subsequent falls in older persons. Medicine & science in sport & exercise 2004; 2046-52.
39. Wolf SL, Sattin RW, Kutner M, O'Grady M, Greenspan Al, Gregor RJ. Intense Tai Chi exercise training and fall occurrences in older, transitionally frail adults: a randomized, controlled trial. J Am Geriatr Soc 2003;51:1693-701.
40. Verhagen AP, Immink M, van der Meulen A, Bierma-Zeinstra SMA. The efficacy of Tai Chi Chuan in older adults: a systematic review, Fam Pract 2004;21:107-13.
41. Tennstedt S, Howland J, Lachman M, et al. A randomized, controlled trial of a group intervention to reduce fear of falling and associated activity restriction in older adults. J Gerontol B Psychol Sci Soc Sci 1998;53:384-92.
42. Pynoos J, Sabata D, Abernethy GD, Alley D, Nishita C, Overton J. Prevention falls at home: Home and environ-mental modification, in preventing falls in older Californians: State of the art. A California blueprint for fall prevention: a background document for the conference, 2003.
43. Campbell AJ, Spears GF, Borne MJ. Examination by logistic regression modeling of the variables which increase the relative risk of elderly women falling compared to elderly men. J Clin Epidemiol 1990;43:1415-20.
44. Pallit D. The Effects of the Program for the Prevention of Falling Accidents at Home among The Elderly in Sriprachan District Suphanburi Province. A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Science (Public Health Nursing) Faculty of Graduate Studies. Mahidol University, Bangkok, Thailand, 2001.
45. Pootong C. The Effect of Risk Reduction Program on Fall Prevention Behaviors of Elderly at Home. A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Nursing Science. Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand, 2002.
2. Tideiksaar R. Falls in older people: prevention and management. 2nd ed. Baltimore: Health Professions Press; 1998.
3. Masud T, Morris RO. Epidemiology of falls. Age and ageing 2001:30:3-7.
4. Rubenstein LZ, Powers CM, MacLean CH. Quality Indicators for the Management and Prevention of Falls and Mobility Problems in Vulnerable Elders. Ann Intern Med 2001;135:686-93.
5. Jitapunkul S, NaSongkhla M, Chayovan N, et al. Falls and their associated factors: a national survey of the Thai elderly. J Med Assoc Thai 1998;81:233-42.
6. Assuntachai P, Praditsuwun R, Thammalikit V. The health promotion and prevention of instability and its complication in the elderly by geriatricians. National Research Council of Thailand 1999.
7. Hanjangsit H, Incident and Factors Related to Home Accident of the Elderly in Yasothorn Province. A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Science. Faculty of Graduate Studies, Mahidol University, Bangkok, Thailand, 1994.
8. Yompuk S. Factors related to home accidents of the elderly in Ratchaburi province. A Thesis submitted in Partial Fulfillment of the Requirements for the Degree of Master of Science (Epidemiology), Faculty of Graduate Studies, Mahidol University, Bangkok, Thailand, 1997.
9, Treeyawuttiwat S. Factors related to home accidents of the elderly in Nakhonprathom province. A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Science (Public Health Nursing).Faculty of Graduate Studies, Mahidol University, Bangkok, Thailand, 2001.
10. Lausawatchaikul P, Factors and the Consequences of Falls in the elderly. A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Nursing Science. Faculty of Graduate Studies, Mahidol University, Bangkok, Thailand, 2000.
11. Fleming BE, Pendergast DR. Physical condition, activity pattern, and environment as factors in falls by adult care facility residents. Arch Phys Med Rehabil 1993; 74: 627-30.
12. American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the Prevention of Falls in Older Persons. JAGS 2001;49:664-72.
13. Nuffield Institute for Health, University of Leeds and NHS Center for Reviews and Disseminations. Prevention and subsequent injury in older people. Effective Healthcare 1996;2:1-16.
14. Rubenstein LZ, Josephson KR. The epidemiology of falls and syncope. Clin Geriatr Med 2002;18:141-58.
15.Jitmontri N, Phasynun N, Ronritthiwichai J. The House Environment that Caused the Fall-accident to the Elderly. J NURS (Mahidol Univ) 1998: 16: 34-45.
16. Luecknofte AG, Gerontologic nursing, 2nd ed. St. Louis: Mosby, 2000.
17. Berg K, Wood-Dauphinee S, Williams JI, Maki B, Measuring balance in the elderly: validation of an instrument. Can J Publ Health 1992:2 (Suppl):304-11.
18. Nelson RC, Amin MA, Falls in elderly, Emerg Med Clin North Am 1990;8:309-24.
19. Tinetti ME, Doucette J, Claus E, Marottoli R. Risk factors for serious injury during falls by older persons in the community. J Am Geriatr Soc 1995;43:1214-21.
20. Roach ss. Introductory gerontological nursing. Philadelphia: Lippincott; 2001.
21. Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall-related injuries in older adults. Am J Publ Health 1992;82:1020-3.
22. Schoenfelder DP, Crowell CM. From Risk for Trauma to Unintentional Injury Risk: Falls - A Concept Analysis. Nursing Diagnosis 1999;10:149-57.
23. Kosorok MR, Omenn GS, Diehr P, Koepsell TD, Patrick DL. Restricted activity days among older adults. Am J Publ Health 1992;82:1263-7.
24. Rubenstein LZ, Josephson KR, Robbins AS. Falls in the nursing home. Ann Intern Med 1994;121:442-51.
25. Rubenstein LZ, Powers CM, MacLean CH. Quality Indicators for the Management and Prevention of Falls and Mobility Problems in Vulnerable Elders. Ann Intern Med 2001;135:686-93.
26. Brown AP. Reducing falls in elderly people: A review of exercise interventions. Physiother Theory Pract 1999;15:59-68.
27. Maki BE, Holliday PJ, Topper AK. Fear of falling and postural performance in the elderly. J Gerontol 1991;46:M 123-131.
28. Arfken CL, Lach HW, Birge SJ, Miller JP. The prevalence and correlates of fear of falling in elderly persons living in the community. Am J Public Health 1994;84:565-70.
29. Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BH. Interventions for preventing falls in elderly people (Cochrane Review). The Cochrane Library 2004: Issue 1.
30. Hill-Westmoreland EE, Soeken K, Spelibring AM. A meta-analysis of fall prevention programs for the elderly: how effective are they? Nursing Research 2002;51:1-8.
31. Robertson MC, Campbell AJ, Gardner MM, Devlin N. Preventing injuries in older people by preventing falls: a meta-analysis of individual-level data. J Am Geriatr Soc 2002;50:905-11.
32. Weatherall M. Preventing of falls and fall-related fracture in community- dwelling older adults: a meta-analysis of estimates of effectiveness based on recent guidelines. Intern Med 2004;34:102-8,
33. Chang JT, Morton SC, Rubenstein LZ, et al. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. Br Med J 2004; 328:680-3.
34. Gardner MM, Robertson CM, Campbell JA. Exercise in preventing falls and fall related injuries in older people; a review of randomized controlled trials. Br J Sports Med 2000;34:7-17.
35. Fiatarone MA, O'Neill EF, Ryan ND, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. N Eng J Med 1994;330:1769-75.
36. Province MA, Hadley EC, Hornbrook MC, et al. The effects of exercise on falls in elderly patients. A preplanned meta-analysis of the FICSIT Trials Frailty and Injuries: Cooperative Studies of Intervention Techniques. JAMA 1995;273:1341-7.
37. Wolf SL, Barnhart HX, Kutner NG, McNeely E, Coogler C, Xu T. Deducing frailty and falls in older persons: an investigation of Tai Chi and computerised balance training. Atlanta FICSIT Group. Frailty and injuries; cooperative studies of intervention
techniques. J Am Geriatric Soc 1996;44:489-97.
38. Li F, Harmer P, Fisher KJ, Mcauley E. Tai Chiะ improving functional balance and predicting subsequent falls in older persons. Medicine & science in sport & exercise 2004; 2046-52.
39. Wolf SL, Sattin RW, Kutner M, O'Grady M, Greenspan Al, Gregor RJ. Intense Tai Chi exercise training and fall occurrences in older, transitionally frail adults: a randomized, controlled trial. J Am Geriatr Soc 2003;51:1693-701.
40. Verhagen AP, Immink M, van der Meulen A, Bierma-Zeinstra SMA. The efficacy of Tai Chi Chuan in older adults: a systematic review, Fam Pract 2004;21:107-13.
41. Tennstedt S, Howland J, Lachman M, et al. A randomized, controlled trial of a group intervention to reduce fear of falling and associated activity restriction in older adults. J Gerontol B Psychol Sci Soc Sci 1998;53:384-92.
42. Pynoos J, Sabata D, Abernethy GD, Alley D, Nishita C, Overton J. Prevention falls at home: Home and environ-mental modification, in preventing falls in older Californians: State of the art. A California blueprint for fall prevention: a background document for the conference, 2003.
43. Campbell AJ, Spears GF, Borne MJ. Examination by logistic regression modeling of the variables which increase the relative risk of elderly women falling compared to elderly men. J Clin Epidemiol 1990;43:1415-20.
44. Pallit D. The Effects of the Program for the Prevention of Falling Accidents at Home among The Elderly in Sriprachan District Suphanburi Province. A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Science (Public Health Nursing) Faculty of Graduate Studies. Mahidol University, Bangkok, Thailand, 2001.
45. Pootong C. The Effect of Risk Reduction Program on Fall Prevention Behaviors of Elderly at Home. A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Nursing Science. Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand, 2002.
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2007-09-28
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Piphatvanitcha N, Kespichayawattana J, Aungsuroch PCY, Magilvy JK. State of Science: Falls Prevention. Program. In Community-Dwelling Elders. Thai J Surg [Internet]. 2007 Sep. 28 [cited 2024 May 4];28(3):90-7. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/241055
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