Intervenciones para reducir los riesgos multifactoriales de caídas

This article provides an overview of common intervention strategies used to prevent falls and fall-related injuries in older people. Fall incidence increases with age and causes a tremendous amount of morbidity, mortality, and use of healthcare services. Major risk factors for falling are diverse, and many of them -such as balance impairment, unsteady gait, muscle weakness, drug side effects, and environmental hazards- are potentially modifiable. Medical assessment of fall risks and provision of appropriate interventions is challenging due to the complex nature of falls. Consensus panels of experts have developed evidence-based practice guidelines for fall prevention and management. Numerous fall prevention strategies have been studied, and there is considerable evidence to suggest that certain types of fall prevention strategies are more effective than others. Findings from individual studies have been substantiated by careful meta-analysis of large numbers of controlled clinical trials. These meta-analyses have concluded that the most effective (and cost-effective) fall reduction programs involve systematic fall risk assessment and targeted interventions, exercise programs, and environmental inspection and hazard reduction programs. One large recent meta-analysis showed that interventions using multidimensional risk assessment and risk reduction lowered the risk of falling by 18%, while exercise reduced the risk of falls by 12%. Home modification was effective when incorporated into a multi-factorial intervention, targeted to fall-prone individuals. These findings indicate that the most promising approaches to fall prevention will involve interdisciplinary collaboration in assessment and interventions.