Cochrane · systematic review · CD012221
Multifactorial and multiple component interventions for preventing falls in older people living in the community
Hopewell, S, Adedire, O, Copsey, BJ, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
Bone, Joint and Muscle TraumaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
32
current version
GRADE rated
19
No studies
13
Included studies
NR
No studies 13 · 40.6%Ungraded 0 · 0%Very low 5 · 15.6%Low 12 · 37.5%Moderate 2 · 6.3%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Multifactorial interventions compared with usual care or attention control for preventing falls in older people living in the community
Population: Older people living in the community
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of falls (falls per person years) Multifactorial interventions vs usual care or attention control | Rate ratio 0.77 [0.67, 0.87] | 19 studies · 5853 participants | Low Downgraded: risk of bias, inconsistency |
Number of people sustaining one or more falls Multifactorial interventions vs usual care or attention control | RR 0.96 [0.9, 1.03] | 29 studies · 9637 participants | Low Downgraded: risk of bias, inconsistency |
Number of people sustaining recurrent falls (defined as 2 or more falls in a specified time period) Multifactorial interventions vs usual care or attention control | RR 0.87 [0.74, 1.03] | 12 studies · 3368 participants | Low Downgraded: risk of bias, inconsistency |
Number of people sustaining one or more fall‐related fractures Multifactorial interventions vs usual care or attention control | RR 0.73 [0.53, 1.01] | 9 studies · 2850 participants | Low Downgraded: risk of bias, imprecision |
Number of people who experience a fall that required hospital admission Multifactorial interventions vs usual care or attention control | RR 1 [0.92, 1.07] | 15 studies · 5227 participants | Low Downgraded: risk of bias, indirectness |
Number of people who experience a fall that required medical attention Multifactorial interventions vs usual care or attention control | RR 0.91 [0.75, 1.1] | 8 studies · 3078 participants | Low Downgraded: risk of bias, imprecision |
Health‐related quality of life Multifactorial interventions vs usual care or attention control | no estimate extracted | 9 studies · 2373 participants | Low Downgraded: risk of bias, inconsistency |
Adverse effects Multifactorial interventions vs usual care or attention control | no estimate extracted | NR | No studies |
Multifactorial interventions compared with exercise for preventing falls in older people living in the community
Population: Older people living in the communityb
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of falls (falls per person years) Multifactorial interventions vs exercise | Rate ratio 0.13 [0.01, 2.46] | 1 study · 51 participants | Very low Downgraded: risk of bias, imprecision |
Number of people sustaining one or more falls Multifactorial interventions vs exercise | RR 0.26 [0.01, 5.52] | 1 study · 51 participants | Very low Downgraded: risk of bias, imprecision |
Number of people sustaining recurrent falls (defined as two or more falls in a specified time period) Multifactorial interventions vs exercise | no estimate extracted | NR | No studies |
Number of people sustaining one or more fall‐related fractures Multifactorial interventions vs exercise | no estimate extracted | NR | No studies |
Number of people who experience a fall that required hospital admission Multifactorial interventions vs exercise | no estimate extracted | NR | No studies |
Number of people who experience a fall that required medical attention Multifactorial interventions vs exercise | no estimate extracted | NR | No studies |
Health‐related quality of life Multifactorial interventions vs exercise | no estimate extracted | NR | No studies |
Adverse effects Multifactorial interventions vs exercise | no estimate extracted | NR | No studies |
Multiple component interventions compared with usual care or attention control for preventing falls in older people living in the community
Population: Older people living in the community
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of falls (falls per person years) Multiple component interventions vs usual care or attention control | Rate ratio 0.74 [0.6, 0.91] | 6 studies · 1085 participants | Moderate Downgraded: risk of bias |
Number of people sustaining one or more falls Multiple component interventions vs usual care or attention control | RR 0.82 [0.74, 0.9] | 11 studies · 1980 participants | Moderate Downgraded: risk of bias |
Number of people sustaining recurrent falls (defined as two or more falls in a specified time period) Multiple component interventions vs usual care or attention control | RR 0.81 [0.63, 1.05] | 4 studies · 662 participants | Low Downgraded: risk of bias, imprecision |
Number of people sustaining one or more fall‐related fractures Multiple component interventions vs usual care or attention control | RR 0.5 [0.05, 5.32] | 2 studies · 232 participants | Very low Downgraded: risk of bias, imprecision |
Number of people who experience a fall that required hospital admission Multiple component interventions vs usual care or attention control | RR 3.06 [0.65, 14.42] | 1 study · 99 participants | Very low Downgraded: risk of bias, imprecision |
Number of people who experience a fall that required medical attention Multiple component interventions vs usual care or attention control | RR 0.95 [0.67, 1.35] | 1 study · 291 participants | Low Downgraded: risk of bias, imprecision |
Health‐related quality of life Multiple component interventions vs usual care or attention control | no estimate extracted | 4 studies · 391 participants | Low Downgraded: risk of bias, inconsistency |
Adverse effects Multiple component interventions vs usual care or attention control | no estimate extracted | NR | No studies |
Multiple component interventions compared with exercise for preventing falls in older people living in the community
Population: Older people living in the community
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of falls (falls per person years) Multiple component interventions vs exercise | Rate ratio 0.92 [0.77, 1.1] | 1 study · 191 participants | Low Downgraded: risk of bias, imprecision |
Number of people sustaining one or more falls Multiple component interventions vs exercise | RR 0.93 [0.78, 1.1] | 3 studies · 863 participants | Low Downgraded: risk of bias, imprecision |
Number of people sustaining recurrent falls (defined as two or more falls in a specified time period) Multiple component interventions vs exercise | no estimate extracted | NR | No studies |
Number of people sustaining one or more fall‐related fractures Multiple component interventions vs exercise | no estimate extracted | NR | No studies |
Number of people who experience a fall that require hospital admission Multiple component interventions vs exercise | RR 1.95 [0.52, 7.41] | 1 study · 97 participants | Very low Downgraded: risk of bias, imprecision |
Number of people who experience a fall that require medical attention Multiple component interventions vs exercise | no estimate extracted | NR | No studies |
Health‐related quality of life Multiple component interventions vs exercise | no estimate extracted | NR | No studies |
Adverse effects Multiple component interventions vs exercise | no estimate extracted | NR | No studies |