Tweaks to falls guidelines could have big impact
New research from NeuRA and UNSW paves the way to helping older people receive the personalised fall prevention interventions they need to reduce their risk.
Research conducted by Neuroscience Research Australia and UNSW has discovered that two simple changes to the world falls guidelines algorithm could dramatically improve the risk classification of older adults.
With falls increasing across the world, this alteration could prove vital when it comes to prevention, with previous findings showing that falls prevention programs – particularly exercise-based interventions – can halve the number of falls.
Senior principal research fellow and director of the Falls, Balance and Injury Research Centre at NeuRA, Professor Stephen Lord, said the 2022-developed World Guidelines for Falls Prevention and Management could not accurately identify people at moderate risk of falls.
By refining the algorithm and incorporating a broader timed-up-and-go test, they can now identify accurately those who are at intermediate risk and likely to move to high fall rates over the medium to long term.
“We were surprised that the original world falls guidelines fall prediction algorithm could not identify many older people at a moderate risk of falls, but by making two simple changes to it, this was possible,” Professor Lord told Australian Ageing Agenda.
“Importantly, the modified algorithm does not need any equipment, as it relies on a medical history, a few questions and a simple timed mobility test (the timed-up-and-go test), so it can be used in a doctor’s surgery. With this information, more tailored interventions can be targeted to those at low, moderate and high risk of falls.”
The proposed changes have important implications for care providers who work with older Australians because they could improve how falls risk is classified and enhance the effectiveness of falls prevention interventions, he said.
Falls are Australia’s leading cause of injury, hospitalisation and death and cost the economy over $2.3 billion annually.
Study findings
The research involved 693 people aged 70-90 and made comparisons between the original and modified algorithms. It found that the modified algorithm successfully identified 18 per cent of participants as intermediate risk, compared to almost none with the original.
Despite having lower rates of falls, the results showed the group shared characteristics with the high-risk group, suggesting the modified algorithm could better identify those who would benefit from targeted fall prevention, stunting their progression to high risk.
“The high-risk group had more than double the fall rate of the low-risk group and community living older people. For these individuals, we recommend multifactorial interventions such as addressing risk factors like hypotension, frailty, balance and mobility impairments, depressive symptoms and fear of falling,” Professor Lord said.
“This improvement in the algorithm is expected to lead to better triaging of older adults, ensuring they receive the personalised fall prevention interventions needed to reduce their risk.”
He said that the changes to the world falls guidelines would represent a notable step towards lowering the burden of falls, improving quality of life and potentially saving lives.
Next steps
Professor Lord and his team are working on identifying older people at risk of falls using smart watches they can use in everyday life.
“We are also evaluating how well step training programs can prevent falls in older people and clinical groups such as those with chemotherapy induced neuropathy,” Professor Lord told AAA.
“These interventions use entertaining step exergames as well as trip and slip training on a walkway and on a treadmill in a virtual reality environment.”
Comment on the story below. Follow Australian Ageing Agenda on LinkedIn, X (Twitter) and Facebook, sign up to our twice-weekly newsletter and subscribe to our premium content or AAA magazine for the complete aged care picture.
