Researchers analyzed 22 studies, finding that reducing hazards and adding aides in the home reduced falls in older people by 26%.

Researchers from the University of Sydney in Australia analyzed several studies on people aged 65 and older to determine how to reduce the incidence of falls in the home.

They found that decluttering and reducing hazards benefitted older people at risk of falls, for example, because they have recently had a fall and been hospitalized or need support with daily activities such as dressing or using stairs.

The review did not find compelling evidence for other measures to reduce falls, such as ensuring older people have the correct prescription glasses, special footwear, or education on avoiding falls.

Nearly one-third of people aged 65 years and older fall each year. Most falls occur in the home.

Lindy Clemson, Professor Emeritus at the University of Sydney, Australia, was the review’s lead author.

“Falls are very common among older people,” said Clemson. “They can cause serious injury or even death, but they are preventable. In this review, we wanted to examine which measures could have the biggest impact on reducing falls among older people living at home.”

Professor Clemson and her colleagues analyzed the results of 22 studies, including data on 8,463 older people living in the community.

They found that taking measures to reduce fall hazards around the home lowers the overall rate of falls by 26%. This typically includes an assessment of fall hazards in and around the home and recommendations for reducing the risk, for instance, by removing clutter and adding handrails and non-slip strips to steps.

These measures have the most significant effect (38% fewer falls) for people at a higher risk of falls. Based on their analyses, the reviewers found that if 1,000 people who had previously had a fall followed these measures for about a year, the total number of falls would decrease from 1,847 to 1,145.

“Having had a fall or starting to need help with everyday activities are markers of underlying risk factors, such as being unsteady on your feet, having poor judgment or weak muscles,” said Clemson. “These risk factors make negotiating the environment more challenging and increase the risk of a trip or slip in some situations.”

While the review showed fewer falls with hazard reduction, there was not enough data from the studies to determine if fewer hospital admissions were due to a fall.

The authors found limited evidence for the other approaches to prevent falls that they examined – assistive technologies and education. They also found there was a lack of research on the impact on fall reduction of providing equipment or modifications to help older people carry out daily activities, such as showering or cooking a meal.

“We encourage all people, as they age, to reduce fall hazards. These are often simple things like removing or changing slippery floor mats, improving lighting on stairs, or decluttering the home,” said Clemson. “It seems this is not always ‘common sense.’ People tend not to notice clutter around their home or realize that climbing ladders the way they always have is potentially a fall risk, particularly if their mobility or balance is not as it used to be.”

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