( only which components to target but al...)Preventing Falls May Be Key to Avoiding Disability in Elderly,Health

only which components to target, but also which audiences to target — older adults, their families, providers or perhaps entire communities.'

Freedman said she was surprised how little evidence she and her colleagues could find about the likely long-term effects of different intervention strategies. Most studies lasted less than a year. This scarcity of evidence is significant, she said, because conclusions about the long run could be very different.

Jon Pynoos, Ph.D., co-director of the Fall Prevention Center of Excellence, said that the review correctly identified medical risk assessment/management, physical activity and environmental modifications as the 'big three' interventions capable of significantly reducing falls.

'Now we need to create ‘real-world’ programs that combine these elements and make them available to persons at moderate to high risk of falls who need them,' he said.

Pynoos said that one challenge is coordinating components from various fields — such as medicine, exercise and home modifications — with different eligibility requirements, reimbursement systems and approaches. It is also important to understand what 'dose' effect or level of each intervention is needed to have an impact, he said.

'At the Fall Prevention Center of Excellence, we are working to create sustainable community-based programs that will serve as models that can be replicated in various settings,'Pynoos said.



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