Fall Risk Awareness Research Articles

Awareness About Fall Risk and Measures of Fall Prevention Among Older Adults in Buraidah, Saudi Arabia.

Background Falls, particularly common among the elderly, pose significant health risks and mortality rates worldwide. Factors such as decline related to old age, gender, medical conditions, and environmental hazards contribute to falls. Prevention strategies focus on environmental modifications, exercise programs, medication reviews, and vitamin D supplementation to reduce fall risks and improve outcomes. This study aims to investigate the awareness of fall risk and measures of fall prevention among older adults in Buraidah, Qassim, Saudi Arabia, and examines the relationship between the level of awareness and various sociodemographic factors. Methodology This cross-sectional study was conducted among elderly patients at primary healthcare centers in Buraidah, Qassim province, Saudi Arabia. Data were collected via an interviewer-administered questionnaire assessing awareness and prevention of falls. Data were cleaned in Excel (Microsoft Corp., Redmond, WA, USA) and analyzed using SPSS version 29 (IBM Corp., Armonk, NY, USA). A linear regression model was used to determine the association. Statistical significance was established at a p-value of 0.05 or lower. Results Our study included 280 elderly participants, of whom 58.2% were female. The mean age was 63.7 years (SD = 4.9), and 34.6% had a bachelor's degree. Regarding fall awareness, 81.4% acknowledged preventability. Notable preventive measures included medication reviews (64.6%), eye examinations (85.7%), physical activity (82.2%), vitamin D supplementation (76.8%), and home safety devices (97.5%). Regarding fall prevention, 61.8% underwent medical examinations annually, and 65.4% had vision checkups. Higher awareness about fall risks was associated with female gender (β = 1.394, 95% confidence interval (CI) = 0.199 to 2.589, p = 0.022), higher education (β = 0.931, 95% CI = 0.549 to 1.314, p < 0.001), and chronic diseases (β = -1.935, 95% CI = -3.313 to -0.556, p = 0.006). Conclusions Our study demonstrates significant awareness among elderly participants regarding fall preventability and measures. Females and those with higher education levels had higher levels of awareness. These findings highlight the importance of targeted interventions to increase awareness and preventive measures among elderly populations.

Development and validation of fall risk perception scale for patients with Parkinson's disease.

Perception assessment plays an important role in fall risk awareness and fall prevention. Parkinson's disease patients with motor dysfunction are at high risk of falling. Currently, no instrument has been explicitly crafted to assess the risk perception of fall in PD patients. The purpose of this study was to develop and validate the fall risk perception scale for PD patients (FRPS-PD), providing healthcare professionals with a effective assessment tool to enhance proactive fall prevention initiatives. Based on the Proactive Health theory and Risk Perception Attitude (RPA) Framework, the questionnaire was developed through literature review, semi-structure interview, expert consultation and pilot testing. A total of 428 patients with PD from Grade A tertiary hospitals in Shanghai, Hangzhou and Anhui from January 2023 to July 2023 were recruited. The items and dimensions in the scale were explored and confirmed using item-analysis, content validity, exploratory factor analytical (EFA), confirmatory factor analytical (CFA), internal consistency and test-retest reliability analysis. A total of 16-items, 2-dimensions structure were identified, including 12 items of risk perception and 4 items of self-efficacy dimension. The cumulative variance of EFA model was 73.669%, further CFA showed that acceptable model fit (χ2/df = 2.226, RMSEA = 0.074, NF = 0.928, TLI = 0.951, CFI = 0.959, GFI = 0.887 and AGFI = 0.848). The content validity index was 0.956. The reliability of the scale was 0.952 using Cronbach's α coefficient method. The test-retest reliability was 0.944. The FRPS-PD is a valid and reliable measurement for evaluating fall risk perception level for individuals with PD in mainland China.

Examining the impact of a health report card on follow through with fall risk recommendations: an observational study

BackgroundIncreasing older adults’ awareness of their personal fall risk factors may increase their engagement in fall prevention. The purpose of this study was to explore the impact of and participant satisfaction with a comprehensive occupational therapy fall risk screening and recommendations for evidence-based fall prevention strategies based on personalized fall risk results for community-dwelling older adults.MethodsCognitively normal participants (Clinical Dementia Rating = 0) were recruited from an ongoing longitudinal study of memory and aging. Participants completed 2 annual in-home visits, fall risk questionnaires, and 12 months of fall monitoring between visits. Participants received a health report card with their fall risks and tailored recommendations in 6 domains. Participants completed follow-up questions at their next annual in-home visit about the fall risk recommendations and their satisfaction with receiving their fall risk results.ResultsTwo hundred five participants completed 2 annual visits and 12 months of fall monitoring. Of the 6 domains of recommendations provided, participants were most likely to follow through with getting an annual eye exam and reviewing their medications with their doctor or pharmacist. Older adults who fell were significantly more likely to receive recommendations for finding fall prevention classes (p = 0.01) and having a doctor or pharmacist review their medications (p = 0.004). The majority of participants were satisfied receiving their fall risk results (92%) and believed it to be beneficial (90%), though few participants shared their results with their doctor (20%).ConclusionsAn occupational therapy fall risk screening and tailored recommendations were not sufficient to encourage follow through with fall risk recommendations. Older adults may benefit from additional support and encouragement to reduce their fall risk. Additional research is needed to examine awareness of fall risks and follow through with fall risk recommendations among community-dwelling older adults.

Practices of Physiotherapists on the Risk of Falls and Prevention in Clients Aged 65 and Older: Online Survey Results

Purpose: Physiotherapists frequently interact with older adults. We aimed to determine the physiotherapists’ practices for fall risk and prevention in clients at 65 years and older. &#x0D; Material and Methods: 72 physiotherapists responded to online survey including questions about demographic and professional characteristics, the awareness and practices of physiotherapists on falling and preventing falls. &#x0D; Results: 91.7% of physiotherapists reported that fall risk should be determined in all clients at 65 years and older. 30.6% of them stated that they evaluated the risk of falling in case of necessity, 83.3% stated that they did not use a standard assessment-treatment flow chart for risk of falling. In elderly clients with low or no risk of falling, 8.1% of physiotherapists; In elderly clients with high risk of falling 83.3% of physiotherapist applied a preventive physiotherapy approach to prevent falls. 67.9% of physiotherapists provide training and advice on fall prevention to elderly clients with low or no fall risk; 73.5% prefer assistive device reclamation in elderly clients with a high risk of falling.&#x0D; Conclusion: Interventions should be planned to improve fall risk awareness and practices among physiotherapists by following a standard assessment-treatment flow chart for their clients 65 years and older.

Fatores associados à capacidade funcional em pessoas idosas no serviço de emergência

Abstract Objective To relate sociodemographic, economic and clinical variables and having or not having a caregiver, risk for falls and perception of the risk for falls with the functional capacity of older adults in an Emergency Department. Methods Analytical cross-sectional study of 197 older adults conducted in the Emergency Department between September 2019 and March 2020. A questionnaire with sociodemographic, economic and clinical information was applied, as well as the instruments: Falls Risk Awareness Questionnaire, Morse Falls Scale, Katz Index and Lawton Scale. The Kruskal Wallis test was used to compare the Katz Index and the Lawton Scale, and the Spearman correlation coefficient was used to associate the Morse Falls Scale with continuous variables. The Mann-Whitney test and the Kruskal Wallis test were used to associate the Falls Risk Awareness Questionnaire with the categorical variables. Results Illiterate patients (p&lt;0.0001) with lower income (p=0.0446) had a lower score on the Katz Index, that is, they presented a higher percentage of totally dependent people. Divorced older adults (p=0.0004) without a caregiver (p&lt;0.0001) had a higher score on the Lawton Scale, that is, a greater degree of independence. The greater perception of risk for falls (p=0.0403) was associated with less independence for instrumental activities of daily living. The low risk for falls (p&lt;0.0001) was associated with greater independence for instrumental activities of daily living. There was no association between perceived risk for falls (p=0.2693) and risk for falls (p=0.4984) with the Katz Index. Conclusion Lower education and income were associated with dependence for activities of daily living. Being divorced and not having a caregiver were associated with independence in instrumental activities of daily living. There was no association between the perception of risk for falls and the risk for falls with activities of daily living. The greater perception of risk for falls was associated with less independence, and the low risk for falls was associated with greater independence for instrumental activities of daily living.

Knowledge, attitude and practice on fall risk factors and prevention among rural older community-dwellers in Vietnam.

Falls among the elderly are an important global health problem. This study assesses knowledge regarding risk factors of falls, as well as attitudes and practices towards fall prevention among older adults in the rural community. A cross-sectional study was performed in four rural communes in Thai Binh province, Vietnam. A total of 3038 older people were recruited. Knowledge was assessed by using Falls Risk Awareness Questionnaire. Questions about attitudes were based on the Health Belief Model. Other questions regarding attitudes and practices regarding fall prevention were also asked. Multivariate regression was performed to identify associated factors with knowledge, attitudes and practices. Results showed that the mean score of knowledge regarding risk factors of falls was low at 11.37/32. The highest scores were observed in terms of drug aspects, followed by medical condition and behavioural aspects. Older people mostly agreed with perceived severity, susceptibility, benefits and barriers, but their attitudes about cues to action, health motivation and actions were most neutral. Meanwhile, more than half of the participants practised recommended fall preventive measures. To conclude, health education interventions and fall prevention services that enhance community-based fall prevention knowledge, attitudes and practices for older adults should be performed to reduce the burden of falls in this population.

Everyday Experiences of Physical Function and Awareness of Fall Risk in Older Adulthood.

Falls, the leading cause of death and disability among older adults, occur in daily life when the demands of daily activities surpass the ability to maintain balance. An estimated 30% of older adults misestimate their physical function, placing them at greater risk of falling. This study examined how experiences of physical function are linked to awareness of fall risk in daily life. For 30 consecutive days following a fall-risk assessment, 41 older adults (observations = 1,135; 56% women; age: 65-91) self-assessed objective and subjective fall risk using a custom smartphone application. Alignment of objective and subjective fall risk was indexed as awareness of fall risk. Postural sway was measured by the application. Physical and mobility symptoms and fear of falling were reported daily. At baseline, 49% of participants misestimated their fall risk. Awareness of fall risk varied from day to day and fall risk was misestimated on 40% of days. Multilevel multinomial models showed individual differences in the level of daily symptoms to increase the tendency to misestimate fall risk. Daily symptoms and fear of falling increased awareness of high fall risk, but daily symptoms threatened awareness of low fall risk. Findings suggest that misestimation of fall risk is common in older adulthood and informed by appraisals of physical function. Fall prevention strategies could support older adults in understanding their everyday physical function and provide tools to adjust the demands of activities in daily life.

"Before I Could Get Him, He Fell": Experiences, Concerns, and Fall Prevention Strategies of Parents With Young Children.

Little is known about parents' perceptions and prevention strategies regarding childhood falls. In this qualitative study using semi-structured interviews, we sought to describe parental reports of child fall experiences, concerns, and prevention strategies in the home. Sixteen parents with at least one child younger than 18 months were asked about their awareness of fall risks, falls experienced by the child, fall concerns, prevention strategies, and where in the home the child spends time throughout the day. Seven themes emerged: (1) "falls are unexpected," (2) "role of the physical environment," (3) "children's temperament and developmental stage," (4) "physical barriers and baby products," (5) "addressing walking surfaces," (6) "modifying the height of a fall," and (7) "supervision." Parents are aware of in-home fall hazards and actively use strategies to lessen fall risk. Anticipatory guidance should promote evidence-based and evidence-informed prevention strategies and augment effective strategies some parents use to lower fall risk.

Patients' experience with a community pharmacy fall prevention service

BackgroundPharmacists can contribute to fall prevention, by offering services such as fall risk screenings, counselling, and medication reviews. Patient acceptance of the role of pharmacists in fall prevention is crucial. Objective(s)The aim of this study was to explore patients' experience with a community pharmacy fall prevention service. MethodsInterviews were conducted with patients one month after they participated in a pharmacy fall prevention service, in the Netherlands. Patient inclusion criteria for the service were: age ≥ 70 years, use of ≥5 drugs including ≥1 fall risk-increasing drug. The service included a fall risk screening followed by counselling and a medication review. The semi-structured interview guide was based on the consolidated framework for implementation research and included the following topics: outcomes, patient's motivation, and contact with the pharmacy technician. ResultsOf the 91 participants of the fall prevention service, 87 patients were interviewed with a median age of 78.0 years (first quartile [Q1] – third quartile [Q3]: 74.0–84.75) and 46.3% were female. Many patients expressed positive feedback about receiving a medication review. Most patients whose medication was deprescribed expressed to be positive about this. Others were reassured about the appropriateness of their medication use. Patients reported that the service enhanced their awareness about fall prevention. Only a few patients were motivated to adapt their lifestyle. Patients appreciated the attention and contact. ConclusionsPatients see a potential benefit for a community pharmacy falls prevention service, including a medication review. Patient education appeared to enhance their fall risk awareness.

Cultural and Linguistic Adaptation of the Fall Risk Questionnaire-Portuguese Version.

Falls are a major problem among older adults worldwide. Early detection of risk factors is important to decrease the burden of falls. The “Fall Risk Questionnaire” (FRQ) is a screening tool used to assess personal fall risk awareness in older populations, and it is also used as a behavior change tool. The aim of the present study was to undertake a cultural and linguistic adaptation of the FRQ to allow its use in the Portuguese population. To achieve this, we used the sequential method proposed by Beaton and colleagues. Statistical analysis was conducted by computing the intraclass correlation coefficient and Cronbach’s alpha score for intra-observer reliability. The panel revision demonstrated high concordance for all assessed items. The pretesting results indicated that, in general, the FRQ—Portuguese Version (FRQ-VP) was well accepted, and all items were adequate and easy to comprehend. The ICC and Cronbach’s alpha scores indicated high consistency between assessments (p < 0.01; alfa = 0.992). The FRQ-VP seemed to have good reliability and internal consistency. Because the definition of a fall experience may not be clear to the older population, a careful explanation of this item can lead to a better score computation.

Falls among elderly: evidence from hospital settings in Georgia

Abstract Introduction Falls are one of the major public health problems and a leading cause of injury-related morbidity and mortality globally. Around of 80% of fall deaths occur in low- and middle- income countries. Falls are the most common cause of hospitalization among the population aged 65 years and older. According the data from Global Burden of Disease (GBD) Study in Georgia, DALYs from falls exceed the average in LMICs. The aim of this observational study was to explore epidemiological characteristics of fall-related injury among hospitalized elderly patients in Georgia in 2020. Methods This study was designed in the framework of the project iCREATE: Increasing Capacity for Research in Eastern Europe’ funded by the NIH (2D43TW007261). All patients aged 65 and older admitted to hospital settings due fall-related injury in 2020 were identified from the Hospital Registry (included a total of 152 hospitals in the country) of the National Center for Disease Control and Public Health of Georgia. Results A total of 7159 injured patients age 65 and above were admitted to hospitals in Georgia, and among them 4213 were hospitalized due to the falls (60%). Males comprised 30,7% of cases and females - 69,3%. The most common source of hospital arrival was ambulance 2791 (65,0%), followed by private/public transport 1432 (33,3%). The highest number of injuries (43,5%) occurred in Tbilisi (capital of Georgia). The leading cause in fall-related hospitalization was fall on same level. Pelvis and the head were the most common body regions injured accounting for 48,0% and 22,9% of cases, respectively. The highest LOS was 2014 (SD 6,161). 111 patients died due to falls related injury during the study period. Conclusions This study indicates that fall- related injury prevention among elderly population should become a key priority area in Georgia. There is a need for elaborating relevant preventive interventions of falls injuries in population aged 65 years and older. Key messages • Falls are the leading cause of hospitalization of patients 65 years of age and older. • Fall risk awareness campaigns should be the first step to fall prevention among elderly.

Effect of a programme of muscular endurance, balance and gait exercises with and without the use of flexible and minimalist shoes in older women with medial knee osteoarthritis: study protocol for a randomised controlled trial

IntroductionStudies have indicated that gait intervention programmes with minimalist shoes are effective for reducing pain, improving functionality and reducing knee joint overload in older women with knee osteoarthritis (OA). Other...

A Case Management Program at Home to Reduce Fall Risk in Older Adults (the MAGIC Study): Protocol for a Single-Blind Randomized Controlled Trial.

BackgroundIndividual case management programs may be particularly effective in reducing fall risk as they can better identify barriers and facilitators to health recommendations.ObjectiveThis paper describes the protocol for a single-blind, parallel-group randomized controlled trial that aims to investigate the effectiveness and cost-effectiveness of a home-based multifactorial program targeting fall risk factors among people aged 60 years and over who have fallen at least twice in the past 12 months (the MAGIC trial).MethodsOlder people with a history of at least 2 falls in the last year will be divided into 2 groups. The intervention group will receive case management at home for reducing the risk of falls, including a multidimensional assessment, explanation of fall risk factors, and elaboration and monitoring of an individualized intervention plan based on the identified fall risk factors, personal preferences, and available resources. The control group will be monitored once a month. Assessments (clinical data, fall risk awareness, physical and mental factors, safety at home, feet and shoes, and risk and rate of falls) will be carried out at baseline, after 16 weeks of the intervention, and at the posttrial 6-week and 1-year follow-up. After 16 weeks of the intervention, satisfaction and adherence to the intervention will also be assessed. Economic health will be evaluated for the period up to the posttrial 1-year follow-up.ResultsData collection started in April 2021, and we expected to end recruitment in December 2021. This case management program will address multifactorial assessments using validated tools and the implementation of individualized intervention plans focused on reducing fall risk factors.ConclusionsThis trial may provide reliable and valuable information about the effectiveness of case management for increasing fall risk awareness and reducing fall risk in older people.Trial RegistrationBrazilian Clinical Trials Registry (ReBec) RBR-3t85fd; https://ensaiosclinicos.gov.br/rg/RBR-3t85fdInternational Registered Report Identifier (IRRID)DERR1-10.2196/34796

Pilot testing of nurse led multimodal intervention for falls prevention

Patient fall-risk awareness, self-efficacy, and engagement in fall-prevention activities are important aspects of fall-prevention. The current pilot study examined the effect of a nurse-led multimodal intervention on hospitalized adults’ levels of fall risk awareness, self-efficacy, and engagement in fall prevention. Sixty hospitalized older adults in an acute care setting in Florida participated in the study. There were significant differences [pre-test (M = 19.02, SD=1.152) and post-test (M = 21.71, SD=0.527); t (17.355) = 58, p≤.001] on level of fall risk awareness in fall prevention. There were no significant findings for fall self-efficacy and engagement. Study findings suggested that the higher the fall self-efficacy, the higher the engagement. Future research is needed to examine self-efficacy and engagement for fall prevention in larger diverse cohorts of hospitalized older adults.

Awareness of Balance as an Intraindividual Dynamic of Objective and Subjective Experiences of Fall Risk in Daily Life

Falls are life-changing events in older adulthood. With an accurate understanding of balance, older adults can adapt to age-related changes in physical ability without prematurely restricting physical activity. The Daily Balance Project examines the implications of older adults’ awareness of fall risk in daily life. For 30-consecutive days, following a fall-risk assessment, 40 older adults used a smartphone to report balance confidence and then perform four balance assessment and a 30-second sit-to-stand task to measure postural sway and fall-risk. Measures of postural sway showed greater intraindividual variability than balance confidence and fall risk. Multilevel models showed that awareness of balance fluctuated during the study and varied across individual differences in baseline fall-risk. Baseline fall risk also differentiated how balance confidence and postural sway were linked to subsequent momentary fall risk assessments. The findings are discussed within the framework of action-perspectives of adult development and awareness of aging.

New Developments in Views on Aging Research: Variability, Innovative Concepts, and Contextual Perspectives

Views on aging (VoA) such as attitudes toward own aging, awareness of aging or subjective age, have a large impact on outcomes related to positive development in later life. Recent research in this domain has focused on complex research designs and inter-systemic linkages at different levels. Indicators of short-term variability of VoA have increasingly been investigated, linking the respective findings with performance indicators, biomarkers, and trait-like data. In addition, bidirectional relationships of VoA and outcomes over time as well as data contextualizing VoA across historical time may offer new insights on the plasticity of VoA seen in bio-cultural co-construction. The symposium will showcase these recent trends with studies from the U.S. and Germany. First, Zhu and Neupert extend previous studies by linking established VoA indicators with future time perspective, all assessed by means of a daily diary study with 60-90 year-old adults. Kornadt et al. examined the variability of subjective age within a day and the relationship with trait subjective age and cortisol levels. Mejia et al. extend VoA to the area of subjective awareness of fall risks in daily life and links them with physical performance. Wettstein et al. investigate the bidirectional relationship of VoA indicators and perceived stress over time. Finally, we move from the micro to a macro-micro design in Wahl et al.’s presentation addressing historical change in VoA across 20 years in the Berlin Aging Study and in MIDUS. Susanne Wurm will discuss how different levels of VoA analysis will find better interlinkage in the future.

Medications and Falls Experiences among Older People

Purpose: This study aimed to identify the status of drug use and analyze the effects of drug use on falls among older people.Methods: The data were collected from 285 community-dwelling older persons through interviewing with questionnaires and checking participants’ medication prescriptions and the drugs using the Korea Pharmaceutical Information Center’s (KPIC) website. The medications were classified into anatomical and therapeutic divisions based on the medications’ ingredients provided by the KPIC. x2 test, ANOVA, t-test, and logistic regressions were applied to analyze the data.Results: The finding showed that 81.4% of the older adults were taking medications. Older people taking antihyperlipidemic drugs were at 1.79 times higher risk for experiencing a fall (95% CI=1.01~3.16, p=.046), and hypnotic sedative and sleeping pills increased their fall risks 11.06 times (95% CI=1.27~96.07, p=.029) compared to those not taking the medications. Nonsteroidal antiinflammatory agents showed a 2.74 odds ratio (95% CI=1.23~5.73, p=.013) and narcotic analgesics increased the fall experience risk 8.56 times (95% CI=1.02~71.88, p=.048). Those with chronic diseases experienced falls 3.04 times more than those without chronic diseases.Conclusion: The study findings showed medications might be one of the important influencing factors on fall risks among older adults. Raising awareness of fall risks associated with medicines through health education and medication reviews by health professionals should be considered a strategy for preventing older adults' falls.

Clinical Impact of an Analytic Tool for Predicting the Fall Risk in Inpatients: Controlled Interrupted Time Series.

BackgroundPatient falls are a common cause of harm in acute-care hospitals worldwide. They are a difficult, complex, and common problem requiring a great deal of nurses’ time, attention, and effort in practice. The recent rapid expansion of health care predictive analytic applications and the growing availability of electronic health record (EHR) data have resulted in the development of machine learning models that predict adverse events. However, the clinical impact of these models in terms of patient outcomes and clinicians’ responses is undetermined.ObjectiveThe purpose of this study was to determine the impact of an electronic analytic tool for predicting fall risk on patient outcomes and nurses’ responses.MethodsA controlled interrupted time series (ITS) experiment was conducted in 12 medical-surgical nursing units at a public hospital between May 2017 and April 2019. In six of the units, the patients’ fall risk was assessed using the St. Thomas’ Risk Assessment Tool in Falling Elderly Inpatients (STRATIFY) system (control units), while in the other six, a predictive model for inpatient fall risks was implemented using routinely obtained data from the hospital’s EHR system (intervention units). The primary outcome was the rate of patient falls; secondary outcomes included the rate of falls with injury and analysis of process metrics (nursing interventions that are designed to mitigate the risk of fall).ResultsDuring the study period, there were 42,476 admissions, of which 707 were for falls and 134 for fall injuries. Allowing for differences in the patients’ characteristics and baseline process metrics, the number of patients with falls differed between the control (n=382) and intervention (n=325) units. The mean fall rate increased from 1.95 to 2.11 in control units and decreased from 1.92 to 1.79 in intervention units. A separate ITS analysis revealed that the immediate reduction was 29.73% in the intervention group (z=–2.06, P=.039) and 16.58% in the control group (z=–1.28, P=.20), but there was no ongoing effect. The injury rate did not differ significantly between the two groups (0.42 vs 0.31, z=1.50, P=.134). Among the process metrics, the risk-targeted interventions increased significantly over time in the intervention group.ConclusionsThis early-stage clinical evaluation revealed that implementation of an analytic tool for predicting fall risk may to contribute to an awareness of fall risk, leading to positive changes in nurses’ interventions over time.Trial RegistrationClinical Research Information Service (CRIS), Republic of Korea KCT0005286; https://cris.nih.go.kr/cris/search/detailSearch.do/16984

Falls, Fear of Falling, and Preventive Measures in Huntington's Disease: The Perspectives of Individuals with Huntington's Disease and Caregivers inLong-Term Care.

Falls are common in Huntington's disease (HD), which can have serious consequences and may therefore lead to fear of falling (FoF). There is little knowledge about falls or FoF in individuals with HD or about formal and informal caregivers' fear about falls in individuals with HD. To explore prevalence of falls, FoF and fall preventive measures both those applied and those not included in managing falls in individuals with HD and their formal and informal caregivers, and to identify the relationship between FoF and, anxiety, awareness and cognitive functioning respectively. In a multi-center observational cross-sectional study, care-independent and -dependent individuals with HD and their formal and informal caregivers were recruited from six Dutch nursing homes specialized in HD. The participants were assessed by means of questionnaires enquiring about falls, FoF, awareness of fall risk, cognition, anxiety and fall preventive measures. For all included 158 individuals with HD, the fall prevalence over the last 30 days was 28.8%. The prevalence of FoF in individuals with HD, formal caregivers and informal caregivers was 47.6%, 25.6%, and 63.5%, respectively, for care-independent individuals with HD and 46.9%, 26.3%, and 62.0%, respectively, for care-dependent individuals with HD. Anticipatory awareness of fall risks and gender are predictors of FoF in care-independent individuals with HD, though not in the care-dependent group. A combination of fall preventive measures is used in most individuals with HD. Fall prevalence is high and FoF is common in individuals with HD and their caregivers. Gender and anticipatory awareness are risk factors for FoF. In addition to the use of individual multifactorial fall prevention strategies, it is important to support both formal and informal caregivers in coping with falls.

Fall prevention education to reduce fall risk among community-dwelling older persons: A systematic review.

ObjectivesThis review aims to identify types of the existing fall prevention education (FPE) and their effectiveness in promoting fall risk awareness, knowledge and preventive fall behaviour change among community‐dwelling older people.BackgroundFPE is a cost‐effective and helpful tool for reducing fall occurrences.EvaluationThis is a systematic review study using electronic searches via EBSCOHost® platform, ScienceDirect, Scopus and Google Scholar in March 2021. The review protocol was registered with PROSPERO (CRD42021232102). The Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA) statement flow chart guided the search strategy. Articles published from January 2010 to March 2021 were included for quality appraisal using the ‘Transparent Reporting of Evaluations with Non‐randomised Designs’ (TREND) and the ‘Consolidated Standards of Reporting Trials’ (CONSORT) statement for randomised controlled trial studies.Key issuesSix FPE studies selected emphasised on personal health status, exercise and environmental risk factors. These studies reported an increase in fall risk awareness or knowledge and a positive change in fall preventive behaviours. Two studies included nurses as educators in FPE.ConclusionFPE evidently improved awareness or knowledge and preventive fall behaviour change among older adults. Nurses are in great potential in planning and providing FPE for older adults in community settings.Implications for Nursing ManagementExpand nurses' roles in fall prevention programmes in community settings by using high‐quality and evidence‐based educational tools. Highlight the nurse's role and collaborative management in FPE.