The objective of this study was to assess the effectiveness of interventions designed to reduce falls by older people in nursing care facilities and hospitals. 41 trials (25,422 participants) were included. In nursing care facilities, the results from seven trials testing supervised exercise interventions were inconsistent. This was the case too for multifactorial interventions, which overall did not significantly reduce the rate of falls or risk of falling. A post hoc subgroup analysis, however, indicated that where provided by a multidisciplinary team, multifactorial interventions reduced the rate of falls and risk of falling. Vitamin D supplementation reduced the rate of falls but not risk of falling. In hospitals, multifactorial interventions reduced the rate of falls and risk of falling. Supervised exercise interventions showed a significant reduction in risk of falling.
There is evidence that multifactorial interventions reduce falls and risk of falling in hospitals and may do so in nursing care facilities. Vitamin D supplementation is effective in reducing the rate of falls in nursing care facilities. Exercise in subacute hospital settings appears effective but its effectiveness in nursing care facilities remains uncertain.
Cameron ID, Murray GR, Gillespie LD, et al. Interventions for preventing falls in older people in nursing care facilities and hospitals. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD005465