World guidelines for falls prevention and management for older adults: a global initiative
Montero-Odasso M., van der Velde N., Martin FC., Petrovic M., Tan MP., Ryg J., Aguilar-Navarro S., Alexander NB., Becker C., Blain H., Bourke R., Cameron ID., Camicioli R., Clemson L., Close J., Delbaere K., Duan L., Duque G., Dyer SM., Freiberger E., Ganz DA., Gómez F., Hausdorff JM., Hogan DB., Hunter SMW., Jauregui JR., Kamkar N., Kenny R-A., Lamb SE., Latham NK., Lipsitz LA., Liu-Ambrose T., Logan P., Lord SR., Mallet L., Marsh D., Milisen K., Moctezuma-Gallegos R., Morris ME., Nieuwboer A., Perracini MR., Pieruccini-Faria F., Pighills A., Said C., Sejdic E., Sherrington C., Skelton DA., Dsouza S., Speechley M., Stark S., Todd C., Troen BR., van der Cammen T., Verghese J., Vlaeyen E., Watt JA., Masud T., Kaur Ajit Singh D., Aguilar-Navarro SG., Aguilera Caona E., Alexander NB., Allen N., Anweiller C., Avila-Funes A., Barbosa Santos R., Batchelor F., Becker C., Beauchamp M., Birimoglu C., Blain H., Bohlke K., Bourke R., Alonzo Bouzòn C., Bridenbaugh S., Gabriel Buendia P., Cameron I., Camicioli R., Canning C., Alberto Cano-Gutierrez C., Carlos Carbajal J., Cristina Carvalho de Abreu D., Casas-Herrero A., Ceriani A., Cesari M., Chiari L., Clemson L., Close J., Manuel Cornejo Alemǻn L., Dawson R., Delbaere K., Doody P., Dsouza S., Duan L., Duque G., Dyer S., Ellmers T., Fairhall N., Ferruci L., Freiberger E., Frith J., Gac Espinola H., Ganz DA., Giber F., Fernando Gómez J., Miguel Gutiérrez-Robledo L., Hartikainen S., Hausdorff J., Hogan DB., Hooi Wong C., Howe S., Hunter S., Perez Jara J., Jauregui R., Jellema A., Jenni S., Jepson D., Kalula S., Kamkar N., Kaur Ajit Singh D., Anne Kenny R., Kerse N., Kobusingye O., Kressig R., Kwok W., Lamb S., Latham N., Ling Lim M., Lipsitz L., Liu-Ambrose T., Logan P., Lord S., Alves Lourenço R., Madden K., Mallet L., Marín-Larraín P., Marsh DR., Martin FC., Martínez Padilla D., Masud T., Mat S., McGarrigle L., McIlroy B., Melgar-Cuellar F., Menant J., Milisen K., Mimenza A., Moctezuma-Gallegos R., Montero-Odasso M., Morris ME., Muneeb I., Negahban H., Nieuwboer A., Norris M., Ogliari G., Oliveira J., Parodi JF., Perez S., Perracini M., Petrovic M., Ernesto Picado Ovares J., Pieruccini-Faria F., Pighills A., Pinheiro M., Poelgeest E., Ramirez Ulate X., Robinson K., Ryg J., Said C., Sakurai R., Schapira M., Sejdic E., Seppala LJ., Sgaravatti A., Sherrington C., Skelton D., Song Y., Speechley M., Stark S., Sultana M., Suri A., Pin Tan M., Taylor M., Thomsen K., Tiedemann A., Lucia Tito S., Todd C., Troen B., Van der Cammen T., Van der Velde N., Verghese J., Vlaeyen E., Watt J., Welmer A-K., Won Won C., Rixt Zijlstra GA.
Abstract Background falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. Current guidelines are inconsistent, with no up-to-date, globally applicable ones present. Objectives to create a set of evidence- and expert consensus-based falls prevention and management recommendations applicable to older adults for use by healthcare and other professionals that consider: (i) a person-centred approach that includes the perspectives of older adults with lived experience, caregivers and other stakeholders; (ii) gaps in previous guidelines; (iii) recent developments in e-health and (iv) implementation across locations with limited access to resources such as low- and middle-income countries. Methods a steering committee and a worldwide multidisciplinary group of experts and stakeholders, including older adults, were assembled. Geriatrics and gerontological societies were represented. Using a modified Delphi process, recommendations from 11 topic-specific working groups (WGs), 10 ad-hoc WGs and a WG dealing with the perspectives of older adults were reviewed and refined. The final recommendations were determined by voting. Recommendations all older adults should be advised on falls prevention and physical activity. Opportunistic case finding for falls risk is recommended for community-dwelling older adults. Those considered at high risk should be offered a comprehensive multifactorial falls risk assessment with a view to co-design and implement personalised multidomain interventions. Other recommendations cover details of assessment and intervention components and combinations, and recommendations for specific settings and populations. Conclusions the core set of recommendations provided will require flexible implementation strategies that consider both local context and resources.