Cochrane · systematic review · CD013258
Environmental interventions for preventing falls in older people living in the community
Clemson, L, Stark, S, Pighills, AC, et al. · Cochrane Database of Systematic Reviews · 2023 · 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
21
current version
GRADE rated
16
No studies
5
Included studies
NR
No studies 5 · 23.8%Ungraded 0 · 0%Very low 5 · 23.8%Low 8 · 38.1%Moderate 3 · 14.3%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
Home fall‐hazard reduction compared with control (e.g. usual care) for preventing falls in older people living in the community
Population: older people living in the community (included trials conducting pre‐ and/or post‐hospital discharge home visits focusing on fall prevention)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Rate of falls (falls per person‐years) Home fall‐hazard reduction vs control (e.g. usual care) | Rate ratio 0.74 [0.61, 0.91] | 12 studies · 5293 participants | Moderate Downgraded: inconsistency |
Number of people who experienced 1 or more falls Home fall‐hazard reduction vs control (e.g. usual care) | RR 0.89 [0.82, 0.97] | 12 studies · 5253 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Number of people who experienced 1 or more fall‐related fractures Home fall‐hazard reduction vs control (e.g. usual care) | RR 1 [0.98, 1.02] | 2 studies · 1668 participants | Very low Downgraded: risk of bias, imprecision |
Number of people who experienced 1 or more falls that resulted in hospital admission Home fall‐hazard reduction vs control (e.g. usual care) | RR 0.96 [0.87, 1.06] | 3 studies · 325 participants | Low Downgraded: risk of bias, imprecision |
Falls requiring medical attention Rate of falls requiring medical attention Home fall‐hazard reduction vs control (e.g. usual care) | 0.91 [0.58, 1.43] | 3 studies · 946 participants | Low Downgraded: imprecision |
Health‐related quality of life SMD was calculated from 4 studies with EQ‐5D (range 0 to 1), 1 study with SF‐36, and 1 study with WHOQOL‐BREF (range 0 to 100). Higher scores indicate better quality of life. Home fall‐hazard reduction vs control (e.g. usual care) | SMD 0.09 | 6 studies · 1848 participants | Moderate Downgraded: imprecision |
Adverse events Home fall‐hazard reduction vs control (e.g. usual care) | no estimate extracted | 2 studies · 73 participants | Low Downgraded: imprecision |
Assistive technology for vision improvement 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) Assistive technology for vision improvement interventions vs usual care or attention control | Rate ratio 1.12 [0.84, 1.5] | 3 studies · 1489 participants | Low Downgraded: imprecision, inconsistency |
Number of people who experienced 1 or more falls Assistive technology for vision improvement interventions vs usual care or attention control | RR 1.09 [0.79, 1.5] | 3 studies · 1489 participants | Low Downgraded: inconsistency |
Number of people who experienced 1 or more fall‐related fractures Assistive technology for vision improvement interventions vs usual care or attention control | RR 1.22 [0.75, 2] | 2 studies · 976 participants | Very low Downgraded: risk of bias, imprecision |
Number of people who experienced 1 or more hospitalisations following a fall Assistive technology for vision improvement interventions vs usual care or attention control | no estimate extracted | NR | No studies |
Rate of falls requiring medical attention Assistive technology for vision improvement interventions vs usual care or attention control | 0.93 [0.48, 1.82] | 1 study · 276 participants | Very low Downgraded: risk of bias, imprecision |
Health‐related quality of life 1 trial of single‐lens glasses compared with usual glasses (multifocals) reported this outcome using the SF‐12 (range 0 to 100). Higher scores indicate better quality of life. Assistive technology for vision improvement interventions vs usual care or attention control | MD 0.4 | 1 study · 597 participants | Low Downgraded: imprecision |
Adverse events Falls while switching glasses Assistive technology for vision improvement interventions vs usual care or attention control | RR 1 [0.98, 1.02] | 1 study · 597 participants | Low Downgraded: imprecision |
Education interventions compared with control (e.g. usual care) 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) Education interventions vs control (e.g. usual care) | Rate ratio 0.63 [0.37, 1.07] | 1 study · 110 participants | Very low Downgraded: risk of bias, imprecision |
Number of people who experienced 1 or more falls Education interventions vs control (e.g. usual care) | RR 0.84 [0.64, 1.11] | 1 study · 110 participants | Very low Downgraded: risk of bias, imprecision |
Number of people who experienced 1 or more fall‐related fractures Education interventions vs control (e.g. usual care) | RR 1.02 [0.96, 1.08] | 1 study · 110 participants | Low Downgraded: risk of bias, imprecision |
Number of people who experienced 1 or more falls requiring hospitalisation Education interventions vs control (e.g. usual care) | no estimate extracted | NR | No studies |
Number of people who experienced 1 or more falls requiring medical attention Education interventions vs control (e.g. usual care) | no estimate extracted | NR | No studies |
Health‐related quality of life Education interventions vs control (e.g. usual care) | no estimate extracted | NR | No studies |
Adverse events Education interventions vs control (e.g. usual care) | no estimate extracted | NR | No studies |