World guidelines for falls prevention and management for older adults: a global initiative
Authors: 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 ,   the Task Force on Global Guidelines for Falls in Older Adults, Kaur Ajit Singh Devinder , Aguilar-Navarro Sara G , Aguilera Caona Edgar , Alexander Neil B , Allen Natalie , Anweiller Cedric , Avila-Funes Alberto , Barbosa Santos Renato , Batchelor Frances , Becker Clemens , Beauchamp Marla , Birimoglu Canan , Blain Hubert , Bohlke Kayla , Bourke Robert , Alonzo Bouzòn Christina , Bridenbaugh Stephanie , Gabriel Buendia Patricio , Cameron Ian , Camicioli Richard , Canning Colleen , Alberto Cano-Gutierrez Carlos , Carlos Carbajal Juan , Cristina Carvalho de Abreu Daniela , Casas-Herrero Alvaro , Ceriani Alejandro , Cesari Matteo , Chiari Lorenzo , Clemson Lindy , Close Jacqueline , Manuel Cornejo Alemǻn Luis , Dawson Rik , Delbaere Kim , Doody Paul , Dsouza Sabestina , Duan Leilei , Duque Gustavo , Dyer Suzanne , Ellmers Toby , Fairhall Nicola , Ferrucci Luigi , Freiberger Ellen , Frith James , Gac Espinola Homero , Ganz David A , Giber Fabiana , Fernando Gómez José , Miguel Gutiérrez-Robledo Luis , Hartikainen Sirpa , Hausdorff Jeffrey , Hogan David B , Hooi Wong Chek , Howe Simon , Hunter Susan , Perez Jara Javier , Jauregui Ricardo , Jellema Anton , Jenni Suen , Jepson Ditte , Kalula Sebastiana , Kamkar Nellie , Kaur Ajit Singh Devinder , Anne Kenny Rose , Kerse Ngaire , Kobusingye Olive , Kressig Reto , Kwok Wing , Lamb Sallie , Latham Nancy , Ling Lim Mei , Lipsitz Lewis , Liu-Ambrose Teresa , Logan Pip , Lord Stephen , Alves Lourenço Roberto , Madden Kenneth , Mallet Louise , Marín-Larraín Pedro , Marsh David R , Martin Finbarr C , Martínez Padilla Diego , Masud Tahir , Mat Sumaiyah , McGarrigle Lisa , McIlroy Bill , Melgar-Cuellar Felipe , Menant Jasmine , Milisen Koen , Mimenza Alberto , Moctezuma-Gallegos Rogelio , Montero-Odasso Manuel , Morris Meg E , Muneeb Irfan , Negahban Hossein , Nieuwboer Alice , Norris Mireille , Ogliari Giulia , Oliveira Juliana , Parodi José F , Perez Sergio , Perracini Monica , Petrovic Mirko , Ernesto Picado Ovares José , Pieruccini-Faria Frederico , Pighills Alison , Pinheiro Marina , Poelgeest Eveline , Ramirez Ulate Xinia , Robinson Katie , Ryg Jesper , Said Cathy , Sakurai Ryota , Schapira Marcelo , Sejdic Ervin , Seppala Lotta J , Sgaravatti Aldo , Sherrington Cathie , Skelton Dawn , Song Yu , Speechley Mark , Stark Susan , Sultana Munira , Suri Anisha , Pin Tan Maw , Taylor Morag , Thomsen Katja , Tiedemann Anne , Lucia Tito Susana , Todd Chris , Troen Bruce , Van der Cammen Tischa , Van der Velde Nathalie , Verghese Joe , Vlaeyen Ellen , Watt Jennifer , Welmer Ana-Karim , Won Won Chang , Rixt Zijlstra G A 
Published: September 2022

Background

falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. Current guidelines are inconsistent, with no up-to-date, globally applicable ones present.

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.