Interventions to Reduce Fear of Falling in Community-Living Older People: A Systematic Review

Authors

  • G. A. Rixt Zijlstra MSc,

    1. From the *Faculty of Health, Medicine and Life Sciences, Department of Health Care Studies, Maastricht University, Maastricht, the NetherlandsCare and Public Health Research Institute, Maastricht, the NetherlandsFaculty of Health and Technology, Professional University Zuyd, Heerlen, the Netherlands§School of Psychology, University of Southampton, Southampton, United Kingdom.
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  • Jolanda C. M. Van Haastregt PhD,

    1. From the *Faculty of Health, Medicine and Life Sciences, Department of Health Care Studies, Maastricht University, Maastricht, the NetherlandsCare and Public Health Research Institute, Maastricht, the NetherlandsFaculty of Health and Technology, Professional University Zuyd, Heerlen, the Netherlands§School of Psychology, University of Southampton, Southampton, United Kingdom.
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  • Erik Van Rossum PhD,

    1. From the *Faculty of Health, Medicine and Life Sciences, Department of Health Care Studies, Maastricht University, Maastricht, the NetherlandsCare and Public Health Research Institute, Maastricht, the NetherlandsFaculty of Health and Technology, Professional University Zuyd, Heerlen, the Netherlands§School of Psychology, University of Southampton, Southampton, United Kingdom.
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  • Jacques Th. M. Van Eijk PhD,

    1. From the *Faculty of Health, Medicine and Life Sciences, Department of Health Care Studies, Maastricht University, Maastricht, the NetherlandsCare and Public Health Research Institute, Maastricht, the NetherlandsFaculty of Health and Technology, Professional University Zuyd, Heerlen, the Netherlands§School of Psychology, University of Southampton, Southampton, United Kingdom.
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  • Lucy Yardley PhD,

    1. From the *Faculty of Health, Medicine and Life Sciences, Department of Health Care Studies, Maastricht University, Maastricht, the NetherlandsCare and Public Health Research Institute, Maastricht, the NetherlandsFaculty of Health and Technology, Professional University Zuyd, Heerlen, the Netherlands§School of Psychology, University of Southampton, Southampton, United Kingdom.
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  • Gertrudis I. J. M. Kempen PhD

    1. From the *Faculty of Health, Medicine and Life Sciences, Department of Health Care Studies, Maastricht University, Maastricht, the NetherlandsCare and Public Health Research Institute, Maastricht, the NetherlandsFaculty of Health and Technology, Professional University Zuyd, Heerlen, the Netherlands§School of Psychology, University of Southampton, Southampton, United Kingdom.
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  • An abstract of this paper was presented at the Annual Scientific Meeting of the Gerontological Society of America, Dallas, Texas, November 16–20, 2006.

Address correspondence to Rixt Zijlstra, MSc, Maastricht University, Faculty of Health, Medicine and Life Sciences, Department of Health Care Studies, PO Box 616, 6200 MD Maastricht, the Netherlands. E-mail: R.Zijlstra@zw.unimaas.nl

Abstract

The objective was to assess which interventions effectively reduce fear of falling in community-living older people. An extensive search for relevant literature comprised a database search of PubMed, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials; expert consultation; and manually searching reference lists from potentially relevant papers. Randomized, controlled trials that assessed fear of falling in community-living older people were included. Two independent reviewers extracted data from full papers on study characteristics, methodological quality, outcomes, and process characteristics of the intervention. The search identified 599 abstracts, and 19 papers met the inclusion criteria. Seven of those papers were identified using expert consultation. Fifty-five percent of all validity items and 39% of process characteristic items were fulfilled across the 19 trials. Twelve of the 19 papers were of higher methodological quality. In 11 of these trials, fear of falling was lower in the intervention group than in the control group. Interventions that showed effectiveness were fall-related multifactorial programs (n=5), tai chi interventions (n=3), exercise interventions (n=2), and a hip protector intervention (n=1). Three of these interventions explicitly aimed to reduce fear of falling. Several interventions, including interventions not explicitly aimed at fear of falling, resulted in a reduction of fear of falling in community-living older people. Limited but fairly consistent findings in trials of higher methodological quality showed that home-based exercise and fall-related multifactorial programs and community-based tai chi delivered in group format have been effective in reducing fear of falling in community-living older people.

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