October 2025
Strategies to prevent falls in aged care facilities
By Rebecca Jenkins
Tailored exercise programs, dairy-rich diets and vitamin D supplementation are among the interventions that can help to prevent older people falling in care facilities, according to an Australian-led Cochrane review.
Researchers included 104 trials with 68,964 participants in the Interventions for Preventing Falls in Older People in Care Facilities review, with 33 trials added since the publication was last updated in 2018.
Among the findings, the review concluded that exercise probably reduced the rate of falls and the risk of falling, but only if it was sustained.
Vitamin D supplementation also probably reduced the rate of falls but probably made little or no difference to the risk of falling, the review authors concluded.
Increasing servings of dairy through dietitian assistance with menu design might decrease the risk of falling and fractures.
Coauthor Professor Ian Cameron from the John Walsh Centre for Rehabilitation Research at The University of Sydney, Sydney, told Medicine Today that the latest update incorporated several new trials as well as new methods that have provided clearer conclusions on how to prevent falls in older people living in care facilities.
‘In particular, we now have evidence that exercise probably prevents falls, including in people with cognitive impairment,’ he said.
‘However, it is important that exercise programs are tailored and supervised by a suitably professional trained in falls prevention, such as a physiotherapist.’
Group exercise of moderate to low intensity was shown to be most effective at reducing falls.
Lead author Dr Suzanne Dyer, Senior Research Fellow at Flinders University, Adelaide, said there was also new evidence that ensuring residents have at least 3.5 servings of dairy foods daily might reduce falls and fractures.
‘By incorporating more calcium- and protein-rich foods like milk, cheese and yoghurt into the diet aged care homes were able to reduce the risk of falling,’ Dr Dyer said.
Importantly, the conclusion that vitamin D supplementation probably reduced falls was maintained in this latest update, Professor Cameron added.
‘As residents of care facilities do not get outdoors often, virtually all residents are vitamin D deficient, so everyone should be given vitamin D supplementation routinely – testing to determine whether or not they are deficient is not necessary,’ he said.
The review also found that strong engagement with facility staff and individually tailored interventions were the key to providing effective multifactorial falls prevention approaches, where each resident received an individualised program of falls prevention strategies based on a personal and environmental assessment.
Professor Cameron said individualised assessment should include input from the GP as well as allied health practitioners and nurses working in the facility.
He recommended that GPs engage with facility staff to implement effective falls prevention programs, which could include advising on appropriate use of walking aids or medication changes.
The review has already informed the development of the new Australian National Falls Prevention Guidelines (https://www.safetyandquality.gov.au/our-work/falls-prevention).