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Key components for assessing and promoting safer mobility behaviour in Parkinson’s disease: A modified Delphi study
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Introduction Promoting safer mobility behaviour is an emerging concept that has been suggested as a common-sense approach to fall prevention in people with Parkinson’s disease (PwPD). Despite its potential, there is currently no assessment tool, nor optimal intervention addressing safer mobility behaviour for PwPD. This study aimed to develop a consensus on the key components that should be included in an assessment and intervention targeting safer mobility behaviour in PwPD. Methods A modified Delphi study was conducted over three rounds with two expert panels: (1) people with lived
Empowering safer mobility behaviour for fall prevention in Parkinson’s disease: An allied health perspective
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Introduction Safer mobility behaviour involves the use of protective actions and functional cognitive processes to reduce the chances of falling. Physiotherapists and occupational therapists have a well-established role in improving functional independence however their approach to promoting safer mobility behaviour for fall prevention is unknown. This study aims to understand the perspectives of clinicians and researchers on the nature of safer mobility behaviour and how it is implemented in clinical practice. Methods A qualitative study using focus group discussions was conducted
Co-Producing a Theory-Informed Psychological Intervention to Increase Acceptance of Home Modifications for Fall Prevention.
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Introduction Home modifications are recommended as part of multifactorial fall prevention interventions for adults aged 50+, yet uptake remains inconsistent. Our previous work, including a mixed-methods systematic review and World Café consultations, identified key psychological and social services barriers which are rarely addressed in routine services. This study aimed to review and prioritise these barriers with members of the public and a falls prevention service, to inform the co-production of a psychologically informed intervention to increase acceptance of home modifications. Methods
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Dual-belt Treadmill Training with Open-skill Stepping Tasks in Day-care Rehabilitation Users: Effects on Balance and Cognition
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Introduction: Day-care rehabilitation users are at high risk of falls, and pragmatic interventions deliverable within routine services are needed. Dual-belt treadmill training can provide task-specific balance challenges while maintaining a feasible dose. We examined whether adding dual-belt treadmill balance training to routine rehabilitation is associated with improvements in dynamic balance/mobility and cognition in very old adults. Method: This single-group pre–post study included 47 day-care rehabilitation users (age 81.4±6.7 years). Participants continued routine rehabilitation (strength
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Cost-effectiveness of Integrating Falls Prevention into Primary Healthcare in Rural China: Findings from the FAMILY trial
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Introduction Falls and fall-related injuries are the leading cause of morbidity and mortality for older adults. China’s rapidly aging population and ever-growing demands for available resources has highlighted the need for falls-prevention programs that deliver value for money. FAMILY, a 12-month cluster randomised controlled trial conducted in 128 Chinese rural villages involving 2610 community-dwelling older adults demonstrated that a balance and functional exercise program integrated in the primary healthcare system reduced falls. This study aimed to assess the cost-effectiveness of the
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Hospital falls clinical practice guidelines: a global analysis and systematic review
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Introduction Hospital falls across the globe continue to rise and are responsible for significant patient harm and economic costs to health services. Clinical practice guidelines aim to reduce falls rates through the provision of up-to-date evidenced based recommendations. There is a need to identify and systematically evaluate hospital falls clinical practice guidelines on falls prevention and management across the globe. Method A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and published protocol. Eight
Health Inequities and Fall Risk: Analyzing the Association of the PROGRESS-PLUS Model and the Algorithm Proposed by the WFG
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Introduction: Although global guidelines for fall prevention and management in older adults exist, using the algorithm from the World Guidelines for Falls Prevention and Management for Older Adults (WFG) in low- and middle-income countries is little explored. Evaluating the association between health inequities and fall risk can guide more effective and equitable interventions. The obhective of this study was to assess the association between health inequities, as defined by the PROGRESS-PLUS model, and fall risk according to the algorithm proposed by the WFG in older Brazilian adults. Methods
Motor Skill Acquisition of Safe Falling and Landing as a Strategy for Fall Injury Prevention Across the Adult Life Span
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Background: Falls represent a major public health and occupational safety concern across the adult lifespan, with both incidence and injury severity increasing with age. Data from Afa Insurance, which insures approximately 90% of the Swedish workforce, show that workers aged 55 years and older have a twofold increased risk of sustaining fall-related injuries leading to more than 30 days of sick leave. As statutory retirement ages continue to rise, the proportion of older individuals exposed to occupational and daily-life fall hazards is expected to increase further. Despite extensive efforts
Falling through the guidelines: Brain computed tomography findings in the elderly, A DGH experience
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Introduction Falls remain one of the leading causes of emergency department attendance among older adults in England. In 2023/2024 alone, approximately 220,000 emergency admissions were attributed to falls, with mortality from accidental falls continuing to rise despite an overall reduction in incidence. Frail patients frequently present with multimorbidity, polypharmacy, and delirium or dementia, often resulting in a reduced Glasgow Coma Scale (GCS) score unrelated to acute trauma. Current NICE guidelines for head injury assessment may inadvertently lead to over-imaging in this cohort. This
Linking Fall-Risk Scores with Wearable Sensor Metrics in Older Adults from the DARE-FALLSPREDICT studies: Preliminary Findings
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Falls are a leading cause of injury and disability in older adults, yet current predictors have limited accuracy. Continuous monitoring of activity, sleep, and heart rate (HR), combined with clinical assessments such as FRAT-up (Cattelani et al, JMIR, 2015) and the World Falls Guidelines (WFG) score (Montero-Odasso et al, Age Ageing, 2022), may improve personalized fall-risk identification. DARE-FALLSPREDICT and DARE-FALLSPREDICT-GP are ongoing single-center studies recruiting older adults (> 65 y) in Italy, respectively at hospital discharge or from the general population. Participants wear a
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Correlation of Neuro-Qol Lower Extremity Function with legacy scores in older patients after hip fracture: influence of falls
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Introduction Scales for measuring quality of life and functionality are transforming to allow patients to describe how they perceive their health status. In this study, we aimed to use technology to evaluate whether the Neuro-QoL-Lower Extremity Function-CAT (NQoL-CAT) correlates with traditional functional assessment scales (Barthel Index and Functional Ambulation Classification-FAC) in elderly patients with hip fractures and check how history of falls affects it. Method Prospective study that included patients over 69 years admitted to the orthogeriatric unit for 12 months. Sociodemographic
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Navigating Life After a Fall: Experiences of Older Adults and Family Members Following Emergency Care
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Introduction Falls are a leading cause of morbidity among older adults and a common reason for emergency department (ED) attendance. Older adults presenting after a fall are at increased risk of recurrent falls; however, fall prevention and follow-up care after ED discharge are often fragmented. Understanding the experiences of both older adults and their relatives is essential to identify unmet needs and inform improvements in post-fall care. This study aimed to explore experiences of older adults and family members following an ED visit after a fall. Method A qualitative study design was
Unrecovered falls in older adults – Current state of the art and preliminary analysis from the TRAIL study
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Introduction: Frail older adults who fall are often unable to get up without assistance. Such “unrecovered falls” (URFs) occur more frequently than injurious falls yet are particularly critical, as prolonged lying episodes significantly increase the risk of adverse health outcomes. Involving the assisting person in URF assessment may help reduce recall bias in self-reported falls. Because URFs are both common and clinically meaningful, they may serves as an efficient outcome measure, allowing for smaller sample sizes in fall prevention trials compared with those relying on injurious falls
Age- and Fall-Risk–Related Differences in Reactive Balance Responses
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Reactive balance control is critical for fall prevention. The ReBalance study examined trunk, hip, and knee range of motion (ROM) from inertial sensors (Trigno, Delsys) during anterior, posterior, right, and left tilting perturbations with triangular (TRIANG) and trapezoidal (TRAPZ) acceleration profiles, in order to reveal age- and risk-related differences in young adults (N=10, 29.4 ± 5.3 years, 40% female) and older adults at low (N=26, 73.4 ± 7.0 years, 40% female) and high (N=25, 79.7 ± 7.4 years, 60% female) fall risk. Fall risk was assessed using FRAT-up (Cattelani et al, JMIR, 2015)
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Association between IMU-derived Gait Parameters and 12-month Falls after Total Knee Arthroplasty: A Preliminary Study
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Introduction Falls after total knee arthroplasty (TKA) remain a clinically important issue. Previously, we reported that inertial measurement units (IMUs) can quantify early postoperative alterations in gait characteristics, including variability, regularity, and smoothness, but their association with subsequent falls is unclear. This preliminary study examined whether IMU-derived gait parameters measured 3 weeks after TKA for knee osteoarthritis (OA) were associated with falls during the first 12 months after surgery. Method Forty patients aged ≥60 years undergoing primary TKA for knee OA
Implementation of pharmacist falls clinic recommendations in primary care
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Introduction A multidisciplinary falls clinic was established where patients are reviewed by a nurse, physiotherapist, and pharmacist and interventions made to reduce the risk of falls. The pharmacist conducts a structured medication review and fracture risk assessment (FRAX) and provides recommendations to the patient and their GP. The aim of this project was to evaluate the number and type of recommendations made by the pharmacist and whether they are implemented in general practice. Method Patients were included if they attended the falls clinic between 1/1/24 and 1/7/24. Data on
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Managing “long lies” after falls in care homes: early qualitative findings from a mixed-methods study
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Introduction Falls are a major public health problem, costing an estimated £2.3 billion annually in the UK. In older age, falls may leave people unable to get up even with assistance. Without life-threatening symptoms, calls may be triaged as low priority and people may remain on the floor (“long lie”), risking dehydration, pressure injury, muscle damage and psychological distress. This study explored how residential and nursing homes manage residents after a fall while awaiting emergency response. Method Semi-structured online interviews were conducted with 15 managers of residential and
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A feasibility RCT of a digital programme to prevent falls and improve well-being in people living with dementia
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Introduction: Falls are common and costly for people living with Dementia (PLwD). “Keep on Keep up (KOKU),” (https://kokuhealth.com/ [kokuhealth.com]) is a UK National Health Service (NHS) approved tablet-based, digital gamified programme with strength and balance exercises and health literacy games specifically designed WITH older people FOR older people at risk of falls [1]. KOKU-LITE is a dementia-friendly accessible version of KOKU that has been co-developed WITH people living with dementia to suit their needs. This trial aimed to assess the feasibility and acceptability of KOKU-LITE
Approaching Falls in Bromley care homes: Doing more vs doing most?
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Introduction Falls account for 27% of ambulance conveyances to hospital from care homes and Extra Care Housing (ECH) in Bromley, despite ongoing falls prevention and management efforts under the Enhanced Health in Care Homes Framework. In March 2025, a system-wide quality improvement programme was designed to super-charge falls prevention, reduce hospital attendance and improve post-fall care. Methods A multidisciplinary network (care home teams, GPs, community services, acute hospital, and ambulance teams) co-designed the Falls Campaign. This enabled risk stratification of falls and sequelae
Frailty predicts incident falls in community living older adults: a cohort study
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Introduction Frailty, a cumulative decline in physiological systems, is associated with adverse health outcomes including falls. Falls are a significant global public health concern, contributing to morbidity and mortality in older persons, and for frail individuals, can lead to serious damage and psychosocial issues. While a strong association between frailty and falls is consistently demonstrated, there remains a paucity of literature specifically exploring these dynamics in a longitudinal framework. Objectives This prospective cohort study aimed to investigate the association between