Recent Studies Reveal The Key To Preventing Falls And Fractures

Falls can cause fractures, and to prevent them, we must take actions that reduce the risk of falling. In this article, we will examine a massive meta-analysis of studies on fall prevention interventions.

This research compares the effectiveness of different fall and fracture prevention strategies.
You can use these findings to implement these strategies in your own life and reduce your risk of falls and fractures.

Fall Prevention Interventions

A meta-analysis published in July 2021 in the Journal of the American Geriatrics Society compared 192 studies on fall and fracture prevention methods. The analysis included randomized controlled trials with participants aged 65 and older.

Previous meta-analyses considered studies with multiple interventions but could not assess the relative effectiveness of the interventions in each study. This new analysis was able to compare the effectiveness of single interventions.

Savers will not be surprised to learn that the most effective single intervention for preventing falls was exercise.

The most effective single intervention for preventing fall-related fractures was a basic falls risk assessment. That assessment included cardiovascular assessment, a medication review to consider changes or deprescribing, and fracture risk screening.

While exercise was the most effective single intervention, it was not the only successful strategy. Multiple intervention studies with positive results often included assistive technology, environmental assessment and modifications, and quality improvement strategies, as well as exercise and a basic fall risk assessment.

You can deploy each of these strategies in your life. Next, we'll define each intervention and you'll learn how to implement them.

Synopsis

In a meta-analysis of 192 studies on fall and fracture prevention strategies, the most effective single intervention was exercise. Multi-intervention studies with positive results frequently included assistive technology, environmental assessment and modifications, and quality improvement strategies, as well as exercise and a basic fall risk assessment.

Prevention Strategies And How To Use Them

This study offers clear actions you can take to prevent falls and fractures.

Exercise – Exercise is overwhelmingly the most effective intervention, with broad consensus on its benefits to strengthen, balance, and increase muscle and bone mass.

This study considered exercises including gait, balance, and functional training, strength/resistance training, flexibility training, 3D training (e.g., Tai Chi or dance), general physical activity (e.g., walking groups), endurance training, and some other forms of physical activity.

This means you have many exercise options; however, if you want to prevent falls and fractures, exercising is not optional..

Environmental Assessment and Modifications – Some studies examined the impact of environmental assessment and modification. Consider what's in your home and other places you frequent. Are there fall hazards present? That might include rugs that slip and slide, uneven flooring, steps without handrails, overly steep stairs, and furniture that is easy to trip over or knock into. You can consider these possible risks yourself, or you can seek the help of an occupational therapist to make your spaces safer from falls. Make changes that create a safer environment for yourself and others at risk of falling.

Assistive Technology – Assistive technology has been shown to reduce falls. That can include mobility aids, sensory aids, and communication technology. If you’re prescribed mobility aids like canes or walkers, make sure you use them. Forgoing them could lead to falls and injuries. Ensure you have adequate sensory support: regular vision assessments, glasses with the correct prescription, and functional hearing aids if needed. Our ability to sense the world around us accurately correlates to our ability to safely navigate our surroundings.

Quality Improvement Strategies – Many effective multi-intervention studies included “quality improvement strategies”, which are used by clinicians and healthcare providers to enhance patient care. It includes “promotion of self-management, patient education, patient reminders, and motivational interviewing.” Your health outcomes can improve if your doctor does the following:

• Gives you agency to manage your own health interventions
• Supports independent patient education (the learning you're doing right now!)
• Provides you with reminders and clear communication regarding the intervention you're undertaking
• Provide motivational support around the changes that improving your health and reducing your fall risk will require

If your doctor isn't meeting these quality metrics, talk to them about the additional support you want. If they aren't receptive, it may be time to find a new doctor.

Basic Falls Risk Assessment – This strategy uses a holistic assessment of your health to measure and reduce your risk of falls. The researchers broke this assessment down as follows, “Cardiovascular assessment (vital signs, ECG, loop recorder, pacemaker interrogation), medication review (review, modification, withdrawal/deprescribing), fracture risk screening (bone mineral density)”.¹

Cardiovascular health is essential to staying active and getting the exercise you need to build bone. A medication review can facilitate deprescribing. Overprescribing often has side effects that can increase the risk of falls and fractures. Monitoring your bone health is important for understanding your fracture risk level and where you are on your journey to stronger bones. Although bone mineral density is not the sole metric for assessing bone health, it is a measurable aspect that your healthcare provider can evaluate with a DXA scan.

These five prevention strategies were consistently part of effective interventions to reduce falls and fractures in the studies, and they can be part of the actions you take to stay strong, healthy, and independent.

Synopsis

The meta-analysis found that five strategies were common features of multi-intervention studies that successfully reduced falls and fractures: exercise, environmental assessment of fall risk and modification to reduce that risk, attaining and using assistive technology or devices, health care providers improving their quality of care and collaboration with patients, and a more holistic basic falls risk assessment.

A Recent Study Reinforces The Save Institute's Approach

A study published in 2024 in the Medical Journal of Australia drew similar conclusions to the meta-analysis examined above.

“Falls and fall-related injuries may be reduced or prevented using specific exercise interventions involving balance and strength training. Older people at high risk of injury may benefit from a targeted approach that is likely to include exercise and other components, including appropriate management of specific health conditions.”²

This finding emphasizes that as we age, our risk of injury from falls increases and our approaches to avoiding falls should consider our health conditions. This reflects the strategies outlined in the previous study– including obtaining adequate vision care, using hearing aids, addressing mobility issues, undergoing cardiovascular assessments, and ensuring that our homes and other environments are safe and suitable for our physical needs.

The goal of preventing and reversing osteoporosis isn't to achieve a particular bone density measurement. The goal is to prevent fractures and avoid falls to remain healthy, active, and independent. That requires interventions that are more ambitious than the limited, ineffectual, and often risky drugs that doctors tend to prescribe to patients with low bone mineral density.

These studies confirm that the best interventions for achieving your goals are not pharmaceutical; they're behavioral.

Synopsis

A 2024 study reinforces the strategies employed by the Save Institute. Exercise is foundational and reducing the risk of falls requires an individual approach that considers your health conditions and incorporates tools like assistive technology and reducing environmental fall risks.

What This Means To You

The Save Institute has encouraged using multiple simultaneous drug-free interventions since our founding.

The Osteoporosis Reversal Program guides your in using strategies such as exercise, diet, proper sleep habits, vision care, balance training, behavioral and lifestyle changes, and more.

Since exercise is the most impactful intervention for preventing falls, we created an exercise video platform that provides Savers with workouts that accomplish their goals– SaveTrainer. SaveTrainer offers on-demand video workouts guided by professional trainers in a wide variety of disciplines.

Whether you want to improve your balance, try resistance training for the first time, continue your yoga practice, destress with meditation, or incorporate aerobic exercise into your daily routine, SaveTrainer has what you're looking for.

The data is clear: physical activity builds strength and bone while preventing falls and fractures.

References

¹ https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.17375

² https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.52374