Exercise and vitamin D supplements top the list for primary care interventions to prevent falls in older adults, according to a review that will be the basis for updated U.S. Preventive Services Task Force (USPSTF) recommendations.
Some comprehensive multifactorial fall assessment and management interventions can be considered safe options to reduce falls in older adults in the community as well, Yvonne L. Michael, ScD, SM, of Drexel University School of Public Health in Philadelphia, and colleagues reported in the Dec. 21 issue of the Annals of Internal Medicine.
The update to USPSTF recommendations on primary care interventions for fall prevention is due in draft form for public comment soon.
The approach represents a shift for the Task Force from its traditional model, which focused on specific diseases, well-defined preventive interventions, and evidence for improved health outcomes before making recommendations, noted an accompanying article by the USPSTF Geriatric Workgroup.
"However, applying this model to prevention for very old patients has been problematic," they wrote in Annals.
Many geriatric disorders are multifactorial, while older adults are often excluded from clinical trials; and important outcomes -- such as functional disability and quality of life -- may not be measured and reported in ways that are conducive to evidence synthesis and interpretation, they pointed out.
An accompanying editorial by Mary E. Tinetti, MD, of Yale, applauded the USPSTF's willingness to change to better address the needs of older adults.
"The timing is excellent," she wrote in Annals, noting that Medicare will soon cover annual health risk assessment visits and customized prevention plans.
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