Falls prevention interventions for community-dwelling older adults: systematic review and meta-analysis of benefits, harms, and patient values and preferences
Canadian Task Force umbrella work (219 RCTs; 167,864 participants) used network meta-analyses across 59 intervention nodes and highlighted moderate-certainty benefit patterns for supervised long-duration balance/resistance programmes, group Tai Chi, and several non-exercise bundles, with patient-preference data favouring individual delivery of balance/resistance training.
Design
SR + NMA suite for Canadian Task Force on Preventive Health Care; 219 trials (167,864 participants) in the benefits/harms stream; ≥3-month follow-up; 59 intervention nodes; CINeMA / GRADE-style certainty language in abstract.
Benefit patterns (abstract narrative)
- ~21 interventions reached moderate certainty for ≥1 benefit outcome; 14 were exercise-focused, mostly supervised, >2 sessions, >3 months duration.
- Balance / resistance and group Tai Chi classes were repeatedly among modalities with the widest low-to-moderate certainty benefit footprints across fall-related endpoints.
- Walking-only nodes did not reach moderate certainty for benefit in the abstract’s priority list.
Harms / preferences
Vitamin D and many single-component exercise arms: probably minimal adverse-effect signals; patient preference synthesis suggests individual delivery of balance/resistance programmes is more acceptable than group formats (high-certainty preference evidence in abstract).
Evidence hygiene
Primary-care framing for community-dwelling ≥65 y—not a single-style Tai chi efficacy trial; use next to sport-specific balance RCTs without merging nodes.
Publication
Pillay J, Tsouros L, Wilson R, et al. Syst Rev. 2024 Nov 26;13(1):289. PMID 39593159.
Outcomes
- Among ~21 moderate-certainty-benefit interventions, supervised long-duration balance/resistance exercise and group Tai Chi were prominent classes across fall-related endpoints (network meta-analysis of 219 trials).
- Patient preference evidence (29 studies) reported high certainty that individual delivery of balance/resistance fall-prevention programmes was preferred over group delivery.