Key points
- Falls are Australia's leading cause of injury, hospitalisation and death, costing our economy over $2.3 billion annually.
- Two simple modifications to the World Falls Guidelines will change the way falls risk is classified, greatly improving the accuracy and effectiveness of prevention measures.
- These changes could lead to more timely and tailored fall prevention interventions, potentially saving lives and reducing healthcare burden.
Falls are a growing issue globally, but two simple modifications to the World Falls Guidelines could dramatically improve prevention, new research from NeuRA (Neuroscience Research Australia) and UNSW has found.
In a new study published today in Age and Ageing today, researchers found that two simple changes to the World Falls Guidelines algorithm can significantly improve the classification of older adults into low, intermediate and high fall risk groups. This improvement is crucial, as research has shown that falls prevention programs — particularly exercise-based interventions — can reduce falls by up to 50 per cent. However, these programs are most effective when tailored to those with low, moderate and increased falls risk.
Professor Stephen Lord, Senior Principal Research Fellow and Director of the Falls, Balance and Injury Research Centre at NeuRA, said the previous World Guidelines for Falls Prevention and Management, launched in 2022, could not accurately identify people at moderate risk of falls.
"While the Falls Guidelines were developed to assist with identifying risk and supporting prevention, we found the algorithm missed significant groups. By refining the algorithm and incorporating a broader 'Timed Up and Go' test, we can now accurately identify those at intermediate risk and therefore posed to transition to high fall rates over the medium to long term," Prof Lord said.
"This research has significant implications for fall risk assessment and prevention for health care providers working with older people."
Improving falls risk assessment and prevention
These changes have significant implications for healthcare providers who work with older adults. The modified guidelines not only improve how falls risk is classified, but also enhances the effectiveness of falls prevention interventions.
The study compared the original and modified algorithms in 693 people aged 70-90. The modified algorithm successfully identified 18.3% of participants as intermediate-risk, compared to almost none with the original. This group shared characteristics with the high-risk group but had lower rates of falls, suggesting the modified algorithm could more accurately identify those who would benefit from targeted fall prevention, preventing their progression to 'high risk'. "The high-risk group had more than double the fall rate of the low-risk group and community living older people. For these individuals, we recommend multifactorial interventions such as addressing risk factors like hypotension, frailty, balance and mobility impairments, depressive symptoms and fear of falling," Professor Lord said.
"This improvement in the algorithm is expected to lead to better triaging of older adults, ensuring they receive the personalised fall prevention interventions needed to reduce their risk."
A crucial step forward
"The ageing of the Australian population means that the problem of fall-related injuries and deaths will worsen if we fail to take preventive action," Prof Lord said.
"These modifications to the World Falls Guidelines represent a significant step towards reducing the burden of falls, enhancing quality of life and potentially saving lives."
The full report is available at https://academic.oup.com/ageing/article/doi/10.1093/ageing/afae192/7796661
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About NeuRA
Neuroscience Research Australia (NeuRA) is an independent, not-for-profit research institute based in Sydney aiming to prevent, treat and cure brain and nervous system diseases, disorders and injuries through medical research.
