Dr. Mary Tinetti of Yale University School of Medicine in New Haven, Connecticut tells us “Falls are one of the most common health problems experienced by older adults and are a common cause of losing functional independence.” The American Geriatrics Society (AGS) recommends that healthcare professionals use their guidelines as a routine part of healthcare for the elderly. An algorithm for patient assessment provides a road map for evaluating all older people encountered by a health care provider.

• Each step in the algorithm is accompanied by links that present detailed, referenced recommendations.

The bottom line? CAM plays a major role in the AGS approach to preventing falls. Here are the recommendations.

• Minimize Medications
  • Medications have consistently been associated with increased risk of falls.
• Initiate an Individually-tailored Exercise Program
  • Evidence supports the recommendation that exercise, in the form of resistance (strength) training, and balance, gait and co-ordination training, is effective in reducing falls.
  • The reduction in fall rate resulting from exercise is modest (approximately 16%).
• Treat Vision Impairment
  • Although correction should intuitively improve fall risk, there are insufficient data to support this intervention alone.
• Manage Postural Hypotension
  • Modification and simplification of medications, have shown benefit for fall prevention
• Manage Heart Rate and Rhythm Abnormalities
  • Cardiovascular factors are frequently cited as risk factors for falls.
  • Treat as appropriate to correct slow and rapid heart rates.
• Supplement with Vitamin D
  • Vitamin D deficiency is common among older people and impairs muscle strength and possibly neuromuscular function.
  • Provide vitamin D supplements of at least 800 IU per day to older persons with proven vitamin D deficiency.
  • Provide vitamin D supplements of at least 800 IU per day should be considered for people with suspected vitamin D deficiency or who are otherwise at increased risk for falls.
• Manage Foot and Footwear Problems
  • Serious foot problems (ie, moderate or severe bunions, toe deformities, ulcers or deformed nails) predispose older adults to falls.
• Modify the Home Environment
  • Screening the home environment with follow-up for any needed modifications by a health care professional is effective for people with a previous fall history or other fall risk factors.
• Provide Education and Information
  • All fall prevention programs should include education intended to raise the awareness of the older person and/or health care workers about risk factors for falls and inform them about strategies to minimize risk.

1/16/11 20:27 JR

6/10/19. Here is a recent link to the Age-in-Place Guide that might be useful in developing a fall prevention program.