Research indicates that the most effective interventions to prevent falls for persons at moderate to high risk of falls are multi-factorial, including environmental modifications along with risk assessment (including medication management) and physical activity (exercise).
Various types of intervention strategies have been implemented with different target populations and in a variety of settings (Rose, 2002/2003). In general, these intervention strategies include, but are not limited to: (1) fall risk assessment and management (including medication management), (2) physical activity-based interventions, (3) environmental modifications, (4) education, (5) assistive devices, (6) visual interventions, and (7) footwear interventions.
Risk factors associated with falls include intrinsic factors (e.g., age-related physiological changes, impairments to the sensory-nervous system, disorders of the musculoskeletal system, and specific acute and chronic diseases) as well as extrinsic factors (e.g., environmental hazards and obstacles interfering with safe mobility, and medication side effects) (Steinberg, Cartwright, Peel, & Williams, 2000; Tideiksaar, 2001).
Falls have devastating consequences for older adults in terms of morbidity and mortality. For example, falls and fall-related injuries have been the leading cause of injury deaths among older adults (Stevens, 2002/2003). Fall-related hip fractures account for approximately 25 percent of injury deaths among those over age 65, and 34 percent of injury deaths among those aged 85 or older (Peek-Asa & Zwerling, 2003).
According to the data compiled from the 1997 and 1998 National Health Interview Survey, the majority (55%) of fall injuries among older people occurred inside the house, whereas an additional 23% occurred outside but near the house and 22% occurred away from the home (Kochera, 2002). In addition, Gill et al. (2000) reported that older persons who resided in dwelling units that had no stairs fell in the following areas: hallways (10%), bathrooms (13%), kitchens (19%), bedrooms (30%), and living rooms (31%).