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Large-scale study of older people finds no reduction in fractures from falls prevention programmes

12th November 2020 about a 2 minute read

Two ‘screen and treat’ programmes designed to prevent older people falling did not reduce fractures, a study funded by the National Institute for Health Research (NIHR) found.

As part of the largest clinical trial of its kind in the UK, researchers from the University of Warwick and University of Exeter looked at two approaches to preventing falls in older people. 

Their study, published in the New England Journal of Medicine, looked at two programmes both widely used in the health service:

  • The multifactorial fall prevention (MFFP) strategy.  This involves a one-hour assessment with a health professional for eight risk factors for falls. Participants are either given specific advice, referred to their GP for a medication review or referred for physiotherapy-led exercise.
  • The exercise programme, which ran for six months. Participants saw a physiotherapist and exercised at home.

A total of 9,803 people aged over 70 took part in the study (the eldest was 101). People living in the community (not care homes) were screened for falls risk. 

Higher risk of falls

Those at higher risk were given a falls prevention advice booklet then randomly assigned to the MFFP programme, the six-month exercise programme or no further intervention. 

The researchers then used data from NHS Digital, plus general practice records and reports from the participants, to determine how many times they attended hospital with fractures within 18 months. 

Lead author Professor Sallie Lamb of the University of Exeter said: “We need to think about the broader causes of fractures and also understand more about what happens to cause falls.”

"Whilst this is a disappointing result, it shows that we must continue to invest in research and development to reduce fractures in older people." Professor Sallie Lamb, University of Exeter

General health benefits

Co-author Professor Julie Bruce, from Warwick Clinical Trials Unit at the University of Warwick, said: “We saw benefits to the general health of people doing exercise and a short-term reduction in the number of falls after exercise.

“People completing the six-month exercise programme became stronger and their balance improved. But that did not translate into a reduction in fractures in the long term.

“The take home message is that we would encourage older people to do physical activity and keep mobile because of the health benefits.”

The trial was funded by the NIHR’s Health Technology Assessment Programme.