Comparative Effectiveness of Published Interventions for Elderly Fall Prevention: A Systematic Review and Network Meta-Analysis

Peixia Cheng, Liheng Tan, Peishan Ning, Li Li, Yuyan Gao, Yue Wu, David C. Schwebel, Haitao Chu, Huaiqiong Yin and Guoqing Hu
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Peixia Cheng: Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China
Liheng Tan: Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China
Peishan Ning: Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China
Li Li: Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China
Yuyan Gao: Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China
Yue Wu: Department of Environmental and Occupational Health, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China
David C. Schwebel: Department of Psychology, University of Alabama, Birmingham, AL 35294, USA
Haitao Chu: Division of Biostatistics, The University of Minnesota, Minneapolis, MN 55455, USA
Huaiqiong Yin: Central South University Library, 172 Tongzipo Rd., Changsha 410013, China
Guoqing Hu: Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, 110 Xiangya Rd., Changsha 410078, China

IJERPH, 2018, vol. 15, issue 3, 1-14

Abstract: Background: Falls are a major threat to older adults worldwide. Although various effective interventions have been developed, their comparative effectiveness remains unreported. Methods: A systematic review and network meta-analysis was conducted to determine the most effective interventions to prevent falls in community-dwelling adults aged 60 and over. Combined odds ratio (OR) and 95% credible interval (95% CrI) were calculated. Results: A total of 49 trials involving 27,740 participants and 9271 fallers were included. Compared to usual care, multifactorial interventions (MFI) demonstrated the greatest efficacy (OR: 0.64, 95% CrI: 0.53 to 0.77) followed by interventions combining education and exercise (EDU + EXC) (OR: 0.65, 95% CrI: 0.38 to 1.00) and interventions combining exercise and hazard assessment and modification (EXC + HAM) (OR: 0.66, 95% CrI: 0.40 to 1.04). The effect of medical care performed the worst (OR: 1.02, 95% CrI: 0.78 to 1.34). Model fit was good, inconsistency was low, and publication bias was considered absent. The overall quality of included trials was high. The pooled odds ratios and ranking probabilities remained relatively stable across all sensitivity analyses. Conclusions: MFI and exercise appear to be effective to reduce falls among older adults, and should be considered first as service delivery options. Further investigation is necessary to verify effectiveness and suitableness of the strategies to at-risk populations.

Keywords: falls; elderly; prevention; network meta-analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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