Abstract
The aim of this systematic review of randomized controlled trials (RCTs) was to investigate the effects of multifactorial programs on the rate of falls and physical performance in ≥60 years old adults. A systematic literature search was conducted in four databases (PubMed, Scopus, Web of Science and Cochrane Library). A total of 518 articles were identified in the initial search, and six RCTs were finally included. Articles written in English, Portuguese and Spanish and published from January 2009 to May 2020 were included in this study. The methodological quality of the included studies was evaluated by the PEDro scale. A total of 518 studies were identified in the initial search, six RCTs were finally included, and three reached a level 1 of evidence. The findings of this systematic review of RCTs suggest that a physical exercise program, especially exercise group activities, combined with health education or with fall risk home assessment, were the most effective multifactorial program in reducing the rate of falls, although the results were not conclusive in all the studies included. Significant beneficial effects were observed in physical performance, particularly when assessed as gait, mobility and balance, regardless of the components of multifactorial program or exercise. This inconsistency in the results, particularly regarding the rate of falls, together with the variability among the multifactorial programs, suggest that any conclusion must be drawn with caution.
Highlights
Population ageing is a public health problem mainly due to decreased fertility rate and increased life expectancy [1]
Falls have a multifactorial etiology in older people [5] and the differences in the rate of falls between different geographical regions may be due to the frequency of particular intrinsic risk factors for falls [10]
Out of the 518 records identified in the initial search, a total of six articles were included in this systematic review [13,33,34,35,36,37]
Summary
Population ageing is a public health problem mainly due to decreased fertility rate and increased life expectancy [1]. The number of people aged ≥ 60 years is increasing and is projected to be 9.7 billion by 2050 [2], with 425 million older adults aged ≥ 80 years [3]. These facts suggest that, in order to promote health and active aging, European societies must improve their strength of health, long-term care and welfare systems [4]. Falls have a multifactorial etiology in older people [5] and the differences in the rate of falls between different geographical regions may be due to the frequency of particular intrinsic risk factors for falls [10]. Identifying fall risk factors and designing multifactorial interventions are key for the prevention of falls and fall-related injuries [11,12]
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