Prevention of falls in the community

There is strong evidence for interventions to reduce the risk of falling in older age, but the uptake in practice has been remarkably slow and inconsistent.1 Recent meta-analyses and reviews of cost effectiveness show that the best investment for prevention is exercise of high dosage, which includes highly challenging balance training2; home safety for high risk groups3; and, on the basis of one trial, drug risk assessment and drug reviews.4 Better evidence is needed on how to package and deliver the different components of the interventions, in a way that is appropriate for different environments and health systems.1

In the linked randomised trial (doi:10.1136/bmj.c2102), Logan and colleagues assess whether a community falls prevention service can reduce falls in older people.5 They found that a multifaceted falls prevention programme significantly reduced the rate of falls over 12 months (rate ratio 0.45, 95% confidence interval 0.35 to 0.58) in people who call an emergency ambulance after a fall …