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Barriers to participation in a community falls prevention program.

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Trinh Vo; Keith Hill; Sarah Milne; Amelia Crabtree; Liz Dalla Santa; Natasha Brusco, Kelly De Santis, Margaret Thomas, Natasha Layton
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Introduction Falls are a major cause to injuries, loss of independence and healthcare costs for older adults globally. An Australian study identified less than 8% of clients eligible for a 12 week education and exercise falls prevention program participate. The aim of this research was to describe the perspectives of clients, carers and staff on the barriers and enablers to participating in the community falls prevention program; to identify changes to the current model of care in order to improve participation rates. Methods A co-design methodology was used which involved consumer chief

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Interventions for preventing falls in people who have presented to emergency departments

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Luiza Pivotto1; Suzanne Dyer2; Wing Kwok1; Charlotte McLennan1; Sallie Lamb3; Ian Cameron1; Cathie Sherrington1; Marina Pinheiro1
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Introduction: The emergency department (ED) is often the first point of contact with the health system following a fall. After an ED visit for a fall, many will experience subsequent falls and revisit the ED. Although guidelines recommend that ED health care professionals assess fall risk and initiate actions to prevent future falls, there remains substantial uncertainty about the effectiveness of interventions for preventing falls among people who present to the ED. Therefore, we aim to assess the effects of interventions designed to reduce falls in adults and older adults who present to the
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Implementation of a Multifactorial Fall Risk Assessment at North Estonia Medical Centre

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H Lehtmets1; R Kaljurand1; K Zirel1
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Background Falls and fall-related injuries are a common healthcare concern, particularly among patients over the age of 65³. It is estimated that nearly one million patients fall during hospitalization worldwide each year. Of those who fall, 25–30% sustain injuries², and 4–10% suffer serious harm²,⁵. Conducting an individualized assessment enables the application of the most appropriate, evidence-based prevention strategies tailored to each patient¹,⁶. An internal review of patient falls at North Estonia Medical Centre in 2023 showed that preventive actions were not systematically tailored to
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Planning implementation of patient falls preventive education in hospitals: gaining the consumer perspective

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AM Hill1; CY Loo1; ME. Morris2, J Francis-Coad1; S Coulter3; H Heng4; RI Shorr5,6; U Phan4; C Watson3; A Semciw2,4; CM Said7,8; B Rasmussen7,9; S Bunting7; C Etherton-Beer1,3; J Wood1
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Introduction: Falls in hospital can be reduced through education of patients and staff. However, limited evidence exists on how staff can systematically implement patient falls prevention education. Planning implementation with hospital staff may enhance their acceptance, engagement, and delivery of falls education to patients. This study aimed to design an implementation plan with hospital staff to guide the successful delivery of patient falls education. Method: Three participatory workshops using a World Café methodology were conducted in hospitals in Western Australia and Victoria. Staff
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Planning implementation of patient falls preventive education in hospitals: gaining the consumer perspective

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AM Hill1; H Heng2; J Francis-Coad1; C Bulsara3; CY Loo1; A Semciw2,4; CM Said5,6; ME Morris4; S Peterson1
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Introduction Falls in hospital are a serious risk to older patient recovery. Patient education programs that provide falls prevention advice are recommended. Obtaining perspectives of older adults about implementing these programs could improve how health professionals engage with hospital patients to educate them and increase patient enactment of falls prevention advice. Method Two forums, in two states of Australia were conducted using a modified World Café methodology. Older consumers who had previous admissions to hospital, shared their perspectives on three conversation topics: (i)
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Efficacy of perturbation balance training on reducing falls risk – an umbrella review

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Catherine Marx1, Grant Trewartha1, Laura Cordova-Rivera2, Hollie Rice1, Lotte Janssens3, Samantha L Harrison1
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Introduction Avoiding a fall after an unexpected slip or a trip requires rapid reactive balance responses, which may be trained via perturbation balance training (PBT). However, PBT protocols vary and their effectiveness is unclear. This umbrella review explored whether PBT, compared to no or conventional balance training (CBT), is effective in reducing falls risk. Methods Systematic reviews with or without meta-analyses were searched in CINAHL, MEDLINE, AMED, EMBASE, PubMed, PEDro, Cochrane database, and Google Scholar and screened by two reviewers. AMSTAR2 was used for quality assessment
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An alternative admission pathway to the Emergency Department for older people after fall with head injury: A service evaluation

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J Nathan1; M Kapilan1; Edwards S2; C Spice1; QY Tan1
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Introduction Following the NICE head injury guideline update in 2023, the Older Persons Same Day Emergency Care Unit (OSDEC) at Portsmouth Hospitals University NHS Trust updated the admission criteria to include older people (>85 years or >75 years with Parkinson’s Disease) presenting with fall and head injury (without any other significant trauma) on anticoagulation or antiplatelet medications (excluding aspirin monotherapy). Older people are admitted directly to OSDEC from ambulance/community services or are admitted from the Emergency Department (ED). This service evaluation aims to

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Bone health assessment in outpatient clinic for older people who have a history of falls: A Quality Improvement Project

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A Timperley1; K Madden1; V Onn2; C Moss3; J Sirisena4
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Introduction Fragility fractures cause pain, mobility problems and negatively impact on people’s quality of life. Hip fractures have a high mortality rate, with 20% of people dying within 1 year after surgery. Falls increase the risk of fragility fractures. NICE and the National Osteoporosis Group Guidelines recommend a bone health assessment be undertaken in people with a history of falls. The FRAX tool is an easy to use tool to predict osteoporosis risk and guide treatment. Our quality improvement project aimed to improve the number of people having an assessment their bone health when

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System dynamics modelling of fall prevention in community and aged care

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MB Pinheiro1, D Currie2, S Khalatbari Soltani1, A Milat3, A Bauman1, K Howard1, C Sherrington1
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Introduction Economic evidence is essential for guiding decisions on the implementation and scaling of fall prevention strategies. This project aimed to develop and test a system dynamics model to project the health and economic impact of fall prevention initiatives for Australians aged 50 and over in community and residential aged care settings, over the period 2024–2035. Method We updated and expanded an existing system dynamics model of osteoporosis and related health and economic impact in Australia which was originally developed through a participatory approach involving a 32-member
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FRAX® Utilisation in patients admitted following falls: a Baseline evaluation of current practice.

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S Pillai1, J Fish1, I Al-Shakarchi2.
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Compliance with Fracture risk assessment tool (FRAX®) assessment in patients presenting with falls and admitted via acute medical take: a baseline audit in a UK district general hospital Background: Falls are a major risk factor for fragility fractures. The National Osteoporosis Guideline Group (NOGG) recommends fracture risk assessment using FRAX® in eligible patients; however, compliance with this recommendation in routine clinical practice is uncertain Aim: To assess compliance with FRAX® fracture risk assessment in eligible patients admitted following falls. Methods: A retrospective audit

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Implementing British Geriatric Society Guidance on Pragmatic Prescribing to reduce harm in people with moderate and severe frailty

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Dr Rowena de Berker 1, Ðula Alićehajić-Bečić1
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Introduction The BGS recently published ‘Pragmatic prescribing to reduce harm for older people with moderate to severe frailty’ endorsed by RCP, RCGP and RPS. This guidance provides a blood pressure target of 140 – 160 mmHg in patients with a CFS of ≥6. This is more lenient than standard guidelines, acknowledging the risk of overtreatment; a consideration which has not been previously incorporated in conventional blood pressure targets. To integrate this guideline into local prescribers’ practice, translating theory into benefit for our patients, we undertook a quality improvement project
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Cognitive Resource Allocation and Balance Performance in Healthy Young Adults: A Pilot Randomised Crossover Trial Investigating Cognitive Depletion and Replenishment Across Balance Task Intensities

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M K Farlie1; J Choi1; K Choi1; S Jaberzadeh1
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Introduction: Balance control relies on cognition. Studies have found that cognitive resources are more likely to be depleted during complex balance tasks, whereas meditation may aid their replenishment. However, existing research has focused on task complexity rather than intensity. This study addressed this by using the validated 100-point Balance Intensity Scale-Therapist (BIS-T) to objectively define low (<30/100) and high (>70/100) intensity balance tasks. This study aimed to evaluate the feasibility and methodological rigour of the protocol to investigate 1) cognitive resources
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Vasovagal Syncope and Falls in Geriatrics

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Sylvie Sekian1, Ella Davison2, Elba Peter3
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Introduction: Vasovagal syncope is a common condition among older adults and can result in fall-related injuries. The symptoms of vasovagal episodes can be recognised by patients and reduced through self-management strategies. Therefore, increasing patient and family/carer education surrounding this condition could help reduce falls and ultimately reduce hospital admissions. The aim of this QIP was to assess doctors existing practises regarding patients presenting with falls due to vasovagal syncope, patient education, and assessing whether a leaflet providing further information would be
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FRAILTY 360- Holistic review of medications and anticholinergic burden in frail older people in the community

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Femina Ali Thoppil Ali1, Faryal Hussain 1, Priyangani Fernando 2, Sandheesh Ekanayake 3
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Polypharmacy is highly prevalent among frail older adults due to multi-morbidity and is a major contributor to medication-related harm. Of particular concern is anticholinergic burden, resulting from the cumulative use of drugs with anticholinergic properties. In frail older patients, high anticholinergic burden is associated with cognitive impairment, delirium, falls, functional decline, increased hospitalisation and mortality. Careful medication review and reduction of anticholinergic burden are therefore important components of comprehensive geriatric care. Methods: A retrospective review

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Integrating GaitSmart® into Primary Care: A Novel Approach to Falls Prevention

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Emma Debbage
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Introduction Older adults with mobility impairment are at increased risk of falls, often accompanied by fear of falling, frailty, and reduced independence. Within Chiltern Hills Primary Care Network (PCN), a strategic priority is to support older patients with mobility difficulties to reduce falls risk, prevent frailty, and improve overall wellbeing. In 2024, we introduced the GaitSmart digital gait assessment solution to proactively identify and address mobility decline before falls occur or health significantly deteriorates. Methods One Care Coordinator was trained to deliver the GaitSmart
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Are Inappropriate Referrals Really Inappropriate? Evaluating an Open Referral Pathway to a Community Falls Assessment Service

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R Butler1, R Callow1, M Young1
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Introduction Our Falls Service utilises an open referral pathway providing rapid access to multi-factorial assessment. Restrictive eligibility criteria, such as falls history, may limit opportunities for earlier identification of risk factors. Evidence and clinical experience indicate that individuals without previous falls can still benefit from comprehensive assessment. Community-based assessments facilitate identification and management of falls risk, incidental findings, delivery of tailored education, advice and appropriate onward referrals. This evaluation examines the clinical value

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Improving Bone Health in a Frailty Department: A Quality Improvement Project on FRAX Utilisation

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Dr Harriet Hamzelou, Dr Ee-Tienne Ong
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Background: Fragility fractures are a major source of morbidity and mortality in frail, older adults (1). Early identification of osteoporosis risk allows for timely referral, investigation, and management. Baseline practice in the Frailty Department showed no use of FRAX (fracture risk assessment tool), resulting in missed opportunities for prevention (2). Aim: To increase use of FRAX within the Frailty Department to guide referrals to rheumatology, dual-energy X-ray absorptiometry (DEXA) scanning, or initiation of immediate treatment. Methods: Baseline data collection was undertaken to
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The Impact of Floor-Rise Training on Fear of Falling & Floor-Rise Ability in Older Adults Living in the Community.

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S Seeley1; D Skelton1; CW Tan2; B Stansfield1; P Dall1.
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Introduction In older adults, the inability to rise independently after a fall increases the risk of long-lies and associated complications. Up to 65% of individuals attended by ambulance crews post-fall are assisted up without requiring further medical intervention. This study investigated the effectiveness of Floor-Rise Training (FRT) in improving floor-rise ability and reducing fear of falling in community-dwelling older adults. Method This pilot cluster-randomised controlled trial was conducted within five existing Otago exercise classes. Sixty-one participants aged ≥65 years were enrolled
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Mobility after proximal femur fracture - comparison of two surgical procedures: prosthetic replacement vs osteosynthesis

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A ALI1; T LAURENTIUS1; T ZIESCHANG1; J KOSCHATE1; M JESSEL1; J SCHLOTMANN1;
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Introduction: Proximal femur fractures in older adults are common and often lead to lasting mobility impairments. Evidence comparing mobility outcomes between different surgical procedures with early full weight-bearing, such as osteosynthesis and prosthetic replacement, is limited. The aim of this study is to examine differences in mobility outcomes between both procedures to inform future treatment decisions. Method: Patients aged 65 years and older, treated for proximal femur fracture at the Trauma Surgery Unit at the Klinikum Oldenburg in Germany were enrolled. Besides others, the De
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The association between peripheral nerve blocks and postoperative delirium in adults undergoing hip fracture surgery: a systematic review and meta-analysis

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Bethany Davey 1 , Abdul-Hadi Kafagi 2 , Abdullah Bin Sahl 2 , Anand Pillai 2
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Objective To review and synthesise the existing evidence on the effects of peripheral nerve block (PNB) compared with no nerve block on the incidence of postoperative delirium (POD) in adults undergoing hip fracture repair. Methods A systematic search of electronic databases (PubMed, Web of Science, EMBASE, and the Cochrane Library) for relevant literature published from database inception to 1st May 2025 was conducted. Randomised controlled trials with PNBs as an intervention in adults undergoing surgery for hip fractures were selected. Studies that excluded patients with preoperative
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