Falls prevention in community-dwelling older adults

USPSTF2024Grade B

Community-dwelling adults 65+ at increased risk for falls: recommend exercise interventions (gait, balance, functional or resistance training, tai chi). Grade B. Identify increased risk by history of falls or impaired mobility/function.

USPSTF2024Grade C

Community-dwelling adults 65+ at increased risk: individualize the decision to offer multifactorial interventions (risk-factor assessment plus tailored interventions); small net benefit. Grade C. Vitamin D for falls not addressed here, reviewed separately.

World Falls Guidelines2022Grade Strong recommendations (1A to 1B)

Ask older adults opportunistically whether they have fallen in the last 12 months; after a fall or concern, check gait speed (under 0.8 m/s signals high risk; Timed Up and Go over 15 seconds is an alternative). Offer balance and functional exercise at least 3 times weekly, individualized and progressed for at least 12 weeks, adding tai chi or resistance training when feasible. Review medications and deprescribe fall-risk-increasing drugs.