World guidelines for falls prevention and management for older adults: a global initiative.
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Montero-Odasso Manuel, van der Velde Nathalie, Martin Finbarr C, Petrovic Mirko, Tan Maw Pin, Ryg Jesper, Aguilar-Navarro Sara, Alexander Neil B, Becker Clemens, Blain Hubert, Bourke Robbie, Cameron Ian D, Camicioli Richard, Clemson Lindy, Close Jacqueline, Delbaere Kim, Duan Leilei, Duque Gustavo, Dyer Suzanne M, Freiberger Ellen, Ganz David A, Gómez Fernando, Hausdorff Jeffrey M, Hogan David B, Hunter Susan M W, Jauregui Jose R, Kamkar Nellie, Kenny Rose-Anne, Lamb Sarah E, Latham Nancy K, Lipsitz Lewis A, Liu-Ambrose Teresa, Logan Pip, Lord Stephen R, Mallet Louise, Marsh David, Milisen Koen, Moctezuma-Gallegos Rogelio, Morris Meg E, Nieuwboer Alice, Perracini Monica R, Pieruccini-Faria Frederico, Pighills Alison, Said Catherine, Sejdic Ervin, Sherrington Catherine, Skelton Dawn A, Dsouza Sabestina, Speechley Mark, Stark Susan, Todd Chris, Troen Bruce R, van der Cammen Tischa, Verghese Joe, Vlaeyen Ellen, Watt Jennifer A, Masud Tahir, Task Force on Global Guidelines for Falls in Older Adults
Аннотация
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.