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Falls

Part of: Bespoke shallow archive Weizmann

Published online by Cambridge University Press:  01 May 2007

John Davison  and
Sarah Marrinan
John Davison*
Affiliation:
Royal Victoria Infirmary and University of Newcastle-upon-Tyne, UK University of Newcastle-upon-Tyne, UK
Sarah Marrinan
Affiliation:
University of Newcastle-upon-Tyne, UK
*
Address for correspondence: J Davison, Royal Victoria Infirmary, Queen Victoria Road, Newcastle-upon-Tyne NE1 4LP, UK.
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Extract

In the context of an aging population, the importance of falls and their prevention has arguably never been greater. Both injurious and non-injurious falls are a frequent occurrence resulting in potentially devastating physical and social consequences. In recent years, there has been a marked expansion in falls research, meta-analysis, and local and national management guidelines, reflecting increased multidisciplinary professional and public awareness of falls.

Type
Clinical geriatrics
Information
Reviews in Clinical Gerontology , Volume 17 , Issue 2 , May 2007 , pp. 93 - 107
Copyright
Copyright © Cambridge University Press 2008

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References

1National Institute for Clinical Excellence. Falls: The assessment and prevention of falls in older people. London: 2004, Clinical Guideline 21.Google Scholar
2Department of Health. National Service Framework for Older People. London. Department of Health; HMSO 2001.Google Scholar
3Rubenstein, LZ, Robbins, AS, Josephson, KR, Schulman, BL, Osterweil, D. The value of assessing falls in an elderly population. A randomized clinical trial. Ann Intern Med 1990; 113: 308–16.Google Scholar
4Shaw, FE. Falls in cognitive impairment and dementia. Clin Geriatr Med 2002; 18: 159–73.Google Scholar
5Oliver, D, Connelly, JB, Victor, CR et al. Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: systematic review and meta-analyses. BMJ 2007; 334 (7584): 82.Google Scholar
6Rubenstein, LZ, Josephson, KR, Osterweil, D. Falls and fall prevention in the nursing home. Clin Geriatr Med 1996; 12: 881–902.Google Scholar
7The Consumer Safety Unit. Accidents in the elderly. 1986.Google Scholar
8Blake, AJ, Morgan, K, Bendall, MJ et al. Falls by elderly people at home: prevalence and associated factors. Age Ageing 1988; 17: 365–72.Google Scholar
9Campbell, AJ, Borrie, MJ, Spears, GF, Jackson, SL, Brown, JS, Fitzgerald, JL. Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study. Age Ageing 1990; 19: 136–41.Google Scholar
10Downton, JH, Andrews, K. Prevalence, characteristics and factors associated with falls among the elderly living at home. Aging Clin Exp Res 1991; 3: 219–28.Google Scholar
11Prudham, D, Evans, JG. Factors associated with falls in the elderly: a community study. Age Ageing 1981; 10: 141–46.Google Scholar
12Tinetti, ME, Speechley, M, Ginter, SF. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988; 319: 1701–07.Google Scholar
13Berg, WP, Alessio, HM, Mills, EM, Tong, C. Circumstances and consequences of falls in independent community-dwelling older adults. Age Ageing 1997; 26: 261–68.Google Scholar
14Gryfe, CI, Amies, A, Ashley, MJ. A longitudinal study of falls in an elderly population: I. Incidence and morbidity. Age Ageing 1977; 6: 201–10.Google Scholar
15Kannus, P, Parkkari, J, Koskinen, S et al. Fall-induced injuries and deaths among older adults. JAMA 1999; 281: 1895–99.Google Scholar
16Grisso, JA, Kelsey, JL, Strom, BL et al. Risk factors for falls as a cause of hip fracture in women. N Engl J Med 1991; 324: 1326–31.Google Scholar
17Nyberg, L, Gustafson, Y, Berggren, D, Brannstrom, B, Bucht, G. Falls leading to femoral neck fractures in lucid older people. J Am Geriatr Soc 1996; 44: 156–60.CrossRefGoogle ScholarPubMed
18Salkeld, G, Cameron, ID, Cumming, RG et al. Quality of life related to fear of falling and hip fracture in older women: a time trade-off study. BMJ 2000; 320 (7231): 341–46.Google Scholar
19Stevens, JA, Corso, PS, Finkelstein, EA, Miller, TR. The costs of fatal and non-fatal falls among older adults. Injury Prev 2006; 12: 290–95.Google Scholar
20Richardson, DA, Bexton, RS, Shaw, FE et al. Prevalence of carotid sinus syndrome (CSS) in older patients with unexplained or recurrent falls attending accident and emergency facilities [Abstract]. J Am Geriatr Soc 1997; 45: 198.Google Scholar
21Department of Trade and Industry. Home accident surveillance system. London: DTI. HMSO, 1987.Google Scholar
22Donald, IP, Bulpitt, CJ. The prognosis of falls in elderly people living at home. Age Ageing 1999; 28: 121–25.Google Scholar
23Vellas, B, Cayla, F, Bocquet, H, de Pemille, F, Albarede, JL. Prospective study of restriction of activity in old people after falls. Age Ageing 1987; 16: 189–93.Google Scholar
24Cwikel, J, Fried, AV. The social epidemiology of falls among community-dwelling elderly: guidelines for prevention. Disabil Rehabil 1992; 14: 113–21.Google Scholar
25Delbaere, K, Crombez, G, Vanderstraeten, G et al. Fear-related avoidance of activities, falls and physical frailty. A prospective community-based cohort study. Age Ageing 2004; 33: 368–73.Google Scholar
26Tinetti, ME, Liu, WL, Claus, EB. Predictors and prognosis of inability to get up after falls among elderly persons. JAMA 1993; 269: 65–70.CrossRefGoogle ScholarPubMed
27Tinetti, ME, Williams, CS. Falls, injuries due to falls, and the risk of admission to a nursing home. N Engl J Med 1997; 337: 1279–84.Google Scholar
28Murphy, J, Isaacs, B. The post-fall syndrome. A study of 36 elderly patients. Gerontology 1982; 28: 265–70.Google Scholar
29Tinetti, ME, Mendes, dLC, Doucette, JT, Baker, DI. Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. J Gerontol A Biol Sci Med Sci 1994; 49: M140–M147Google Scholar
30Cumming, RG, Salkeld, G, Thomas, M, Szonyi, G. Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. J Gerontol A Biol Sci Med Sci 2000; 55: M299–M305CrossRefGoogle ScholarPubMed
31Hauer, K, Lamb, SE, Jorstad, EC et al. Systematic review of definitions and methods of measuring falls in randomised controlled fall prevention trials. Age Ageing 2006; 35: 5–10.Google Scholar
32Cummings, SR, Nevitt, MC, Kidd, S. Forgetting falls. The limited accuracy of recall of falls in the elderly. J Am Geriatr Soc 1988; 36: 613–16.Google Scholar
33Mackenzie, L, Byles, J, D'Este, C. Validation of self-reported fall events in intervention studies. Clin Rehabil 2006; 20: 331–39.Google Scholar
34Kenny, RA, Traynor, G. Carotid sinus syndrome–clinical characteristics in elderly patients. Age Ageing 1991; 20: 449–54.Google Scholar
35McIntosh, SJ, Lawson, J, Kenny, RA. Clinical characteristics of vasodepressor, cardioinhibitory, and mixed carotid sinus syndrome in the elderly. Am J Med 1993; 95: 203–08.Google Scholar
36NHS Centre for Reviews and Dissemination, Nuffield Institute for Health. Preventing falls and subsequent injury in older people. Effective Health Care Bull 1996; 2: 1–6.Google Scholar
37American Geriatrics Society, British Geriatrics Society, American Academy of Orthopaedic Surgeons Panel on Fall Prevention.. Guideline for the prevention of falls in older persons. J Am Geriatr Soc 2001; 49: 664–72.Google Scholar
38Sheldon, JH. On the natural history of falls in old age. BMJ 1960; 2: 1685–90.CrossRefGoogle ScholarPubMed
39Overstall, PW, Exton-Smith, AN, Imms, FJ, Johnson, AL. Falls in the elderly related to postural imbalance. BMJ 1977; 1 (6056): 261–64.CrossRefGoogle ScholarPubMed
40Lord, SR, Sambrook, PN, Gilbert, C et al. Postural stability, falls and fractures in the elderly: results from the Dubbo Osteoporosis Epidemiology Study. Med J Aust 1994; 160: 684–85.Google Scholar
41Wolfson, L, Whipple, R, Derby, CA et al. A dynamic posturography study of balance in healthy elderly. Neurology 1992; 42: 2069–76.Google Scholar
42Moreland, JD, Richardson, JA, Goldsmith, CH, Clase, CM. Muscle weakness and falls in older adults: a systematic review and meta-analysis. J Am Geriatr Soc 2004; 52: 1121–29.Google Scholar
43Nevitt, MC, Cummings, SR, Kidd, S, Black, D. Risk factors for recurrent nonsyncopal falls. A prospective study. JAMA 1989; 261: 663–68.Google Scholar
44Lord, SR, Ward, JA, Williams, P, Anstey, KJ. Physiological factors associated with falls in older community-dwelling women. J Am Geriatr Soc 1994; 42: 1110–17.Google Scholar
45Harwood, RH. Visual problems and falls. Age Ageing 2001; 30 (suppl): 13–18.CrossRefGoogle ScholarPubMed
46Ivers, RQ, Cumming, RG, Mitchell, P, Attebo, K. Visual impairment and falls in older adults: the Blue Mountains Eye Study. J Am Geriatr Soc 1998; 46: 58–64.Google Scholar
47Campbell, AJ, Borrie, MJ, Spears, GF. Risk factors for falls in a community-based prospective study of people 70 years and older. J Gerontol A Biol Sci Med Sci 1989; 44: 112–17.Google Scholar
48Robbins, AS, Rubenstein, LZ, Josephson, KR, Schulman, BL, Osterweil, D, Fine, G. Predictors of falls among elderly people. Results of two population-based studies. Arch Intern Med 1989; 149: 1628–33.Google Scholar
49Lord, SR, Clark, RD, Webster, IW. Visual acuity and contrast sensitivity in relation to falls in an elderly population. Age Ageing 1991; 20: 175–81.Google Scholar
50Leipzig, RM, Cumming, RG, Tinetti, ME. Drugs and falls in older people: a systematic review and meta-analysis: II. Cardiac and analgesic drugs. J Am Geriatr Soc 1999; 47: 40–50.Google Scholar
51Hartikainen, S, Lonnroos, E, Louhivuori, K. Medication as a risk factor for falls: critical systematic review. J Gerontol A Biol Sci Med Sci 2007; 62: 1172–81.CrossRefGoogle ScholarPubMed
52Hien, lT, Cumming, RG, Cameron, ID et al. Atypical antipsychotic medications and risk of falls in residents of aged care facilities. J Am Geriatr Soc 2005; 53: 1290–95.Google Scholar
53Lee, JS, Kwok, T, Leung, PC, Woo, J. Medical illnesses are more important than medications as risk factors of falls in older community dwellers? A cross-sectional study. Age Ageing 2006; 35: 246–51.Google Scholar
54Waller, JA. Falls among the elderly–human and environmental factors. Acid Anal Prev 1978; 10: 21–23.Google Scholar
55Sattin, RW, Rodriguez, JG, DeVito, CA, Wingo, PA. Home environmental hazards and the risk of fall injury events among community-dwelling older persons. Study to Assess Falls Among the Elderly (SAFE) Group. J Am Geriatr Soc 1998; 46: 669–76.Google Scholar
56van Bemmel, T, Vandenbroucke, JP, Westendorp, RG, Gussekloo, J. In an observational study elderly patients had an increased risk of falling due to home hazards. J Clin Epidemiol 2005; 58: 63–67.Google Scholar
57Northridge, ME, Nevitt, MC, Kelsey, JL, Link, B. Home hazards and falls in the elderly: the role of health and functional status. Am J Public Health 1995; 85: 509–15.Google Scholar
58Kiely, DK, Kiel, DP, Burrows, AB, Lipsitz, LA. Identifying nursing home residents at risk for falling. J Am Geriatr Soc 1998; 46: 551–55.Google Scholar
59Tinetti, ME, Williams, TF, Mayewski, R. Fall-risk index for elderly patients based on number of chronic disabilities. Am J Med 1986; 80: 429–34Google Scholar
60Tencer, AF, Koepsell, TD, Wolf, ME et al. Biomechanical properties of shoes and risk of falls in older adults. J Am Geriatr Soc 2004; 52: 1840–46.CrossRefGoogle ScholarPubMed
61Sherrington, C, Menz, HB. An evaluation of footwear worn at the time of fall-related hip fracture. Age Ageing 2003; 32: 310–14.Google Scholar
62Shaw, FE, Kenny, RA. Can falls in patients with dementia be prevented? Age Ageing 1998; 27: 7–9.Google Scholar
63Rubenstein, LZ, Josephson, KR. The epidemiology of falls and syncope. Clin Geriatr Med 2002; 18: 141–58.Google Scholar
64Davies, AJ, Kenny, RA. Falls presenting to the accident and emergency department: types of presentation and risk-factor profile. Age Ageing 1996; 25: 362–66.Google Scholar
65Shaw, FE, Kenny, RA. The overlap between syncope and falls in the elderly. Postgrad Med J 1997; 73: 635–39.Google Scholar
66McIntosh, S, da Costa, D, Kenny, RA. Outcome of an integrated approach to the investigation of dizziness, falls and syncope in elderly patients referred to a ‘syncope’ clinic. Age Ageing 1993; 22: 53–58.Google Scholar
67Parry, SW, Steen, IN, Baptist, M, Kenny, RA. Amnesia for loss of consciousness in carotid sinus syndrome: implications for presentation with falls. J Am Coll Cardiol 2005; 45: 1840–43.Google Scholar
68Kenny, RA, Kalaria, R, Ballard, C. Neurocardiovascular instability in cognitive impairment and dementia. Ann N Y Acad Sci 2002; 977: 183–95.CrossRefGoogle ScholarPubMed
69Tinetti, ME, Baker, DI, McAvay, G et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med 1994; 331: 821–27.Google Scholar
70Anonymous. Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. The Consensus Committee of the American Autonomic Society and the American Academy of Neurology. Neurology 1996; 46: 1470.Google Scholar
71Campbell, AJ, Reinken, J. Postural hypotension in old age: prevalence, associations and prognosis. J Clin Exp Gerontol 1985; 7: 163–75.Google Scholar
72Thomas, JE, Vinken, PJ, Bruyn, GW. Anon. Disease of the carotid sinus syncope. In: Handbook of Clinical Neurology. Amsterdam: North-Holland Publishing; 1972; 19: 532–51.Google Scholar
73Morley, CA, Sutton, R. Carotid sinus syncope. Int J Cardiol 1984; 6: 287–93.Google Scholar
74Kerr, SR, Pearce, MS, Brayne, C, Davis, RJ, Kenny, RA. Carotid sinus hypersensitivity in asymptomatic older persons: implications for diagnosis of syncope and falls. Arch Intern Med 2006; 166: 515–20.Google Scholar
75Thomas, JE. Hyperactive carotid sinus reflex and carotid sinus syncope. Mayo Clin Proc 1969; 44: 127–39.Google Scholar
76Kenny, RA, Richardson, DA, Steen, N, Bexton, RS, Shaw, FE, Bond, J. Carotid sinus syndrome: a modifiable risk factor for non-accidental falls in older adults (SAFE PACE). J Am Coll Cardiol 2001; 38: 1491–96.Google Scholar
77Parry, SW, Kenny, RA. The management of vasovagal syncope. QJ Med 1999; 92: 697–705.Google Scholar
78Davison, J, Bond, J, Dawson, P, Steen, IN, Kenny, RA. Patients with recurrent falls attending Accident & Emergency benefit from multifactorial intervention–a randomized controlled trial. Age Ageing 2005; 34: 162–68.Google Scholar
79Scott, V, Votova, K, Scanlan, A, Close, J. Multifactorial and functional mobility assessment tools for fall risk among older adults in community, home-support, long-term and acute-care settings. Age Ageing 2007; 36: 130–39.Google Scholar
80Mathias, S, Isaacs, B. Balance in elderly patients: the ‘get-up-and-go’ test. Arch Phys Med Rehab 1986; 67: 387–89.Google Scholar
81Tinetti, ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 1986; 34: 119–26.Google Scholar
82Lord, SR, Clark, RD, Webster, IW. Physiological factors associated with falls in an elderly population. J Am Geriatr Soc 1991; 39: 1194–200.Google Scholar
83Glynn, RJ, Buring, JE. Ways of measuring rates of recurrent events. BMJ 1996; 312 (7027): 364–67.Google Scholar
84Cumming, RG, Kelsey, JL, Nevitt, MC. Methodologic issues in the study of frequent and recurrent health problems. Falls in the elderly. Ann Epidemiol 1990; 1: 49–56.Google Scholar
85Campbell, AJ, Robertson, MC, Gardner, MM, Norton, RN, Tilyard, MW, Buchner, DM. Randomised controlled trial of a general practice programme of home-based exercise to prevent falls in elderly women. BMJ 1997; 315 (7115): 1065–69.Google Scholar
86Robertson, MC, Devlin, N, Gardner, MM, Campbell, AJ. Effectiveness and economic evaluation of a nurse-delivered home exercise programme to prevent falls. 1: Randomised controlled trial. BMJ 2001; 322 (7288): 697–79.Google Scholar
87Campbell, AJ, Robertson, MC, La Grow, SJ et al. Randomised controlled trial of prevention of falls in people aged > or =75 with severe visual impairment: the VIP trial. BMJ 2005; 331 (7520): 817.Google Scholar
88Chang, JT, Morton, SC, Rubenstein, LZ et al. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ 2004; 328 (7441): 680.Google Scholar
89Reinsch, S, MacRae, P, Lachenbruch, PA, Tobis, JS. Attempts to prevent falls and injury: a prospective community study. Gerontologist 1992; 32: 450–56.Google Scholar
90Lord, SR, Ward, JA, Williams, P, Strudwick, M. The effect of a 12-month exercise trial on balance, strength, and falls in older women: a randomized controlled trial. J Am Geriatr Soc 1995; 43: 1198–206.Google Scholar
91McMurdo, ME, Johnstone, R. A randomized controlled trial of a home exercise programme for elderly people with poor mobility. Age Ageing 1995; 24: 425–28.Google Scholar
92Cornillon, E, Blanchon, MA, Ramboatsisetraina, P et al. Effectiveness of falls-prevention strategies for elderly subjects who live in the community with performance assessment of physical activities (before-after). Ann Readapt Med Phys 2002; 45: 493–504.Google Scholar
93Gillespie, LD, Gillespie, WJ, Robertson, MC, Lamb, SE, Cumming, RG, Rowe, BH. Interventions for preventing falls in elderly people. The Cochrane Database of Systematic Reviews 2003;(4): Art. No. CD000340. 10.1002/14651858.Google Scholar
94Skelton, D, Dinan, S, Campbell, M, Rutherford, O. Tailored group exercise (Falls Management Exercise – ME) reduces falls in community-dwelling older frequent fallers (an RCT). Age Ageing 2005; 34: 636–39.CrossRefGoogle Scholar
95Wolf, SL, Barnhart, HX, Kutner, NG, McNeely, E, Coogler, C, Xu, T. Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. Atlanta FICSIT Group. Frailty and Injuries: Cooperative Studies of Intervention Techniques. J Am Geriatr Soc 1996; 44: 489–97.Google Scholar
96Li, F, Harmer, P, Fisher, KJ et al. Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci 2005; 60: 187–94.Google Scholar
97Voukelatos, A, Cumming, RG, Lord, SR, Rissel, C. A randomized, controlled trial of tai chi for the prevention of falls: the Central Sydney tai chi trial. J Am Geriatr Soc 2007; 55: 1185–91.Google Scholar
98Woo, J, Hong, A, Lau, E, Lynn, H. A randomised controlled trial of Tai Chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people. Age Ageing 2007; 36: 262–68.Google Scholar
99Wolf, SL, Sattin, RW, Kutner, M, O'Grady, M, Greenspan, AI, Gregor, RJ. Intense tai chi exercise training and fall occurrences in older, transitionally frail adults: a randomized, controlled trial. J Am Geriatr Soc 2003; 51: 1693–701.Google Scholar
100Wu, G. Evaluation of the effectiveness of Tai Chi for improving balance and preventing falls in the older population–a review. J Am Geriatr Soc 2002; 507: 46–54.Google Scholar
101Lamb, S, Gates, S, Fisher, J et al. Scoping Exercise on Fallers’ Clinics: Report to the National Co-ordinating Centre for NHS Service Delivery and Organisation. The University of Warwick. 2007.Google Scholar
102Harwood, RH, Foss, AJ, Osborn, F, Gregson, RM, Zaman, A, Masud, T. Falls and health status in elderly women following first eye cataract surgery: a randomised controlled trial. Br J Ophthalmol 2005; 89: 53–59.Google Scholar
103McGwin, GJ, Gewant, HD, Modjarrad, K, Hall, TA, Owsley, C. Effect of cataract surgery on falls and mobility in independently living older adults. J Am Geriatr Soc 2006; 54: 1089–94.Google Scholar
104Day, L, Fildes, B, Gordon, I, Fitzharris, M, Flamer, H, Lord, S. Randomised factorial trial of falls prevention among older people living in their own homes. BMJ 2002; 325 (7356): 128.Google Scholar
105Cumming, RG, Thomas, M, Szonyi, G et al. Home visits by an occupational therapist for assessment and modification of environmental hazards: a randomized trial of falls prevention. J Am Geriatr Soc 1999; 47: 1397–402.Google Scholar
106Stevens, M, Holman, CD, Bennett, N, de Klerk, N. Preventing falls in older people: outcome evaluation of a randomized controlled trial. J Am Geriatr Soc 2001; 49: 1448–55.Google Scholar
107Close, J, Ellis, M, Hooper, R, Glucksman, E, Jackson, S, Swift, C. Prevention of falls in the elderly trial (PROFET): a randomised controlled trial. Lancet 1999; 353 (9147): 93–97.Google Scholar
108Cumming, RG, Thomas, M, Szonyi, G, Frampton, G, Salkeld, G, Clemson, L. Adherence to occupational therapist recommendations for home modifications for falls prevention. Am J Occup Ther 2001; 55: 641–48.Google Scholar
109Campbell, AJ, Robertson, MC, Gardner, MM, Norton, RN, Buchner, DM. Psychotropic medication withdrawal and a home-based exercise program to prevent falls: a randomized, controlled trial. J Am Geriatr Soc 1999; 47: 850–53.Google Scholar
110van der Velde, N, Stricker, BHC, Pols, HAP, van der Cammen, TJM. Risk of falls after withdrawal of fall-risk-increasing drugs: a prospective cohort study. Br J Clin Pharmacol 2007; 63: 232–37.Google Scholar
111Stein, MS, Wark, JD, Scherer, SC et al. Falls relate to vitamin D and parathyroid hormone in an Australian nursing home and hostel. J Am Geriatr Soc 1999; 47: 1195–201.Google Scholar
112Bischoff, HA, Stahelin, HB, Dick, W et al. Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res 2003; 18: 343–51.Google Scholar
113Dhesi, JK, Jackson, SH, Bearne, LM et al. Vitamin D supplementation improves neuromuscular function in older people who fall. Age Ageing 2004; 33: 589–95.Google Scholar
114Latham, NK, Anderson, CS, Reid, IR. Effects of vitamin D supplementation on strength, physical performance, and falls in older persons: a systematic review. J Am Geriatr Soc 2003; 51: 1219–26.Google Scholar
115Chapuy, MC, Arlot, ME, Duboeuf, F et al. Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med 1992; 327: 1637–42.Google Scholar
116Lyons, RA, Johansen, A, Brophy, S et al. Preventing fractures among older people living in institutional care: a pragmatic randomised double- blind placebo controlled trial of vitamin D supple-mentation. Osteoporos Int 2007; 18: 811–18.Google Scholar
117Law, M, Withers, H, Morris, J, Anderson, F. Vitamin D supplementation and the prevention of fractures and falls: results of a randomised trial in elderly people in residential accommodation. Age Ageing 2006; 35: 482–86.Google Scholar
118Parker, MJ, Gillespie, WJ, Gillespie, LD. Effectiveness of hip protectors for preventing hip fractures in elderly people: systematic review. BMJ 2006; 332 (7541): 571–74.Google Scholar
119Lightbody, E, Watkins, C, Leathley, M, Sharma, A, Lye, M. Evaluation of a nurse-led falls prevention programme versus usual care: a randomized controlled trial. Age Ageing 2002; 31: 203–10.Google Scholar
120Kingston, P, Jones, M, Lally, F, Crome, P. Older people and falls: a randomized controlled trial of a health visitor (HV) intervention. Rev Clin Gerontol 2001; 11: 209–14.Google Scholar
121Mahoney, JE, Shea, TA, Przybelski, R et al. Kenosha County falls prevention study: a randomized, controlled trial of an intermediate-intensity, community-based multifactorial falls intervention. J Am Geriatr Soc 2007; 55: 489–98.Google Scholar
122van Haastregt, JCM, Diederiks, JPM, van Rossum, E, de Witte, LP, Voorhoeve, PM, Crebolder, HFJM. Effects of a programme of multifactorial home visits on falls and mobility impairments in elderly people at risk: randomised controlled trial. BMJ 2000; 321 (7267): 994–98.Google Scholar
123Gates, S, Fisher, JD, Cooke, MW, Carter, YH, Lamb, SE. Multifactorial assessment and targeted intervention for preventing falls and injuries among older people in community and emergency-care settings: systematic review and meta-analysis. BMJ 2008; 336 (7636):130–33.Google Scholar
124Robbins, AS, Rubenstein, LZ. Postural hypotension in the elderly. J Am Geriatr Soc 1984; 32: 769–74.Google Scholar
125Caine, SE, Alsop, K, MacMahon, M. Overlooking orthostatic hypotension with routine blood-pressure equipment. Lancet 1998; 352 (9126): 458Google Scholar
126National Institute for Clinical Excellence. Bisphosphonates (alendronate, etidronate, risedronate), selective oestrogen receptor modulators (raloxifene) and parathyroid hormone (teriparatide) for the secondary prevention of osteoporotic fragility fractures in postmenopausal women. London. 2005; Technology Appraisal Guidance 87.Google Scholar
127Royal College of Physicians of London and Bone & Tooth Society of Great Britain. Royal College of Physicians ed. Osteoporosis: Clinical guidelines for prevention and treatment. London. 2000.Google Scholar