-
Tytuł:
-
Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement.
-
Autorzy:
-
Grossman DC; Kaiser Permanente Washington Health Research Institute, Seattle.
Curry SJ; University of Iowa, Iowa City.
Owens DK; Veterans Affairs Palo Alto Health Care System, Palo Alto, California.; Stanford University, Stanford, California.
Barry MJ; Harvard Medical School, Boston, Massachusetts.
Caughey AB; Oregon Health & Science University, Portland.
Davidson KW; Columbia University, New York, New York.
Doubeni CA; University of Pennsylvania, Philadelphia.
Epling JW Jr; Virginia Tech Carilion School of Medicine, Roanoke.
Kemper AR; Nationwide Children's Hospital, Columbus, Ohio.
Krist AH; Fairfax Family Practice Residency, Fairfax, Virginia.; Virginia Commonwealth University, Richmond.
Kubik M; Temple University, Philadelphia, Pennsylvania.
Landefeld S; University of Alabama at Birmingham.
Mangione CM; University of California, Los Angeles.
Pignone M; University of Texas at Austin.
Silverstein M; Boston University, Boston, Massachusetts.
Simon MA; Northwestern University, Evanston, Illinois.
Tseng CW; University of Hawaii, Honolulu.; Pacific Health Research and Education Institute, Honolulu, Hawaii.
-
Corporate Authors:
-
US Preventive Services Task Force
-
Źródło:
-
JAMA [JAMA] 2018 Apr 24; Vol. 319 (16), pp. 1696-1704.
-
Typ publikacji:
-
Journal Article; Practice Guideline; Research Support, U.S. Gov't, P.H.S.
-
Język:
-
English
-
Imprint Name(s):
-
Original Publication: Chicago : American Medical Association, 1960-
-
MeSH Terms:
-
Exercise Therapy*/adverse effects
Accidental Falls/*prevention & control
Aged ; Bone Density Conservation Agents/adverse effects ; Bone Density Conservation Agents/therapeutic use ; Dietary Supplements ; Humans ; Independent Living ; Vitamin D/adverse effects ; Vitamin D/therapeutic use
-
Substance Nomenclature:
-
0 (Bone Density Conservation Agents)
1406-16-2 (Vitamin D)
-
Entry Date(s):
-
Date Created: 20180501 Date Completed: 20180509 Latest Revision: 20180509
-
Update Code:
-
20240104
-
DOI:
-
10.1001/jama.2018.3097
-
PMID:
-
29710141
-
Importance: Falls are the leading cause of injury-related morbidity and mortality among older adults in the United States. In 2014, 28.7% of community-dwelling adults 65 years or older reported falling, resulting in 29 million falls (37.5% of which needed medical treatment or restricted activity for a day or longer) and an estimated 33 000 deaths in 2015.
Objective: To update the 2012 US Preventive Services Task Force (USPSTF) recommendation on the prevention of falls in community-dwelling older adults.
Evidence Review: The USPSTF reviewed the evidence on the effectiveness and harms of primary care-relevant interventions to prevent falls and fall-related morbidity and mortality in community-dwelling older adults 65 years or older who are not known to have osteoporosis or vitamin D deficiency.
Findings: The USPSTF found adequate evidence that exercise interventions have a moderate benefit in preventing falls in older adults at increased risk for falls and that multifactorial interventions have a small benefit. The USPSTF found adequate evidence that vitamin D supplementation has no benefit in preventing falls in older adults. The USPSTF found adequate evidence to bound the harms of exercise and multifactorial interventions as no greater than small. The USPSTF found adequate evidence that the overall harms of vitamin D supplementation are small to moderate.
Conclusions and Recommendation: The USPSTF recommends exercise interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. (B recommendation) The USPSTF recommends that clinicians selectively offer multifactorial interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls. Existing evidence indicates that the overall net benefit of routinely offering multifactorial interventions to prevent falls is small. When determining whether this service is appropriate for an individual, patients and clinicians should consider the balance of benefits and harms based on the circumstances of prior falls, presence of comorbid medical conditions, and the patient's values and preferences. (C recommendation) The USPSTF recommends against vitamin D supplementation to prevent falls in community-dwelling adults 65 years or older. (D recommendation) These recommendations apply to community-dwelling adults who are not known to have osteoporosis or vitamin D deficiency.
Summary for patients in:JAMA. 2018 Apr 24;319(16):1734. (PMID: 29710167)
Comment in: Ann Intern Med. 2018 Aug 21;169(4):JC14. (PMID: 30128504)
