Evidence map›Paper›PMID 34318929›Full record

SynthesisJournal of the American Geriatrics Society2021

Interventions for preventing falls and fall-related fractures in community-dwelling older adults: A systematic review and network meta-analysis.

Lauren Dautzenberg, Shanthi Beglinger, Sofia Tsokani, Stella Zevgiti, Renee C M A Raijmann, Nicolas Rodondi, Rob J P M Scholten, Anne W S Rutjes, Marcello Di Nisio, Marielle Emmelot-Vonk and 7 more

Open access · hybridAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of the American Geriatrics Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 109 papers, 18 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
109citing papers in PubMed, 18 pooled it
47.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

109 citing papers in PubMed, 18 syntheses or guidelines pooled it, 188 citations in OpenAlex.

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49 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors at 6 institutions in 6 countries.

Lauren DautzenbergDepartment of Geriatric Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.ORCID 0000-0003-2502-9988
Shanthi BeglingerDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Sofia TsokaniDepartment of Primary Education, School of Education, University of Ioannina, Ioannina, Greece.
Stella ZevgitiDepartment of Primary Education, School of Education, University of Ioannina, Ioannina, Greece.
Renee C M A RaijmannDepartment of Geriatric Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
Nicolas RodondiDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Rob J P M ScholtenCochrane Netherlands/Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
Anne W S RutjesInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Marcello Di NisioDepartment of Medicine and Ageing Sciences, University G. D'Annunzio, Chieti, Italy.
Marielle Emmelot-VonkDepartment of Geriatric Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
Andrea C TriccoLi Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
Sharon E StrausLi Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
Sonia ThomasLi Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
Lisa BretagneDepartment of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Wilma KnolDepartment of Geriatric Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
Dimitris MavridisDepartment of Primary Education, School of Education, University of Ioannina, Ioannina, Greece.
Huiberdina L KoekDepartment of Geriatric Medicine, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
Utrecht University · NLUniversity of Bern · CHSt. Michael's Hospital · CAUniversity of Ioannina · GRDélégation Paris 5 · FRUniversity of Chieti-Pescara · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare the effectiveness of single, multiple, and multifactorial interventions to prevent falls and fall-related fractures in community-dwelling older persons.

methodsMEDLINE, Embase, and Cochrane Central Register of Controlled Trials were systematically searched for randomized controlled trials (RCTs) evaluating the effectiveness of fall prevention interventions in community-dwelling adults aged ≥65 years, from inception until February 27, 2019. Two large RCTs (published in 2020 after the search closed) were included in post hoc analyses. Pairwise meta-analysis and network meta-analysis (NMA) were conducted.

resultsNMA including 192 studies revealed that the following single interventions, compared with usual care, were associated with reductions in number of fallers: exercise (risk ratio [RR] 0.83; 95% confidence interval [CI] 0.77-0.89) and quality improvement strategies (e.g., patient education) (RR 0.90; 95% CI 0.83-0.98). Exercise as a single intervention was associated with a reduction in falls rate (RR 0.79; 95% CI 0.73-0.86). Common components of multiple interventions significantly associated with a reduction in number of fallers and falls rate were exercise, assistive technology, environmental assessment and modifications, quality improvement strategies, and basic falls risk assessment (e.g., medication review). Multifactorial interventions were associated with a reduction in falls rate (RR 0.87; 95% CI 0.80-0.95), but not with a reduction in number of fallers (RR 0.95; 95% CI 0.89-1.01). The following single interventions, compared with usual care, were associated with reductions in number of fall-related fractures: basic falls risk assessment (RR 0.60; 95% CI 0.39-0.94) and exercise (RR 0.62; 95% CI 0.42-0.90).

conclusionsIn keeping with Tricco et al. (2017), several single and multiple fall prevention interventions are associated with fewer falls. In addition to Tricco, we observe a benefit at the NMA-level of some single interventions on preventing fall-related fractures.

Indexed as

Accidental FallsAccidents, HomeAgedAged, 80 and overEnvironment DesignExercise TherapyFemaleFractures, BoneHumansIndependent LivingMaleRandomized Controlled Trials as TopicRisk AssessmentSelf-Help Devicescommunity-dwellingfall-related fracturesfallsolder adults

Identifiers

PMID34318929
PMCPMC8518387
OpenAlexW3184729570

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.