Full bibliography

Falls present a major, growing and neglected public health problem with devastating consequences for older individuals, their families and health care systems. The recently published World guidelines for falls prevention and management for older adults: a global initiative1 (Guidelines) is a comprehensive document that provides extensive recommendations with additional background materials available on an accompanying website. The Guidelines is a consensus document informed by systematic reviews and a Delphi process. This body of work demonstrates that much is known about what works in falls prevention but there is considerable complexity. The main message is that most falls occur due to a loss of balance while upright or walking, and the most important intervention to prevent this is exercise. Rare causes such as cardioinhibitory syncope are also described. The Guidelines includes important messages about the older person's perspective, and which interventions are effective in hospitals and residential aged care facilities. The Guidelines1 explicitly states that although we know what interventions are effective, we still need to know how best to implement these interventions in our busy health systems. This perspective article aims to provide a digestible version of the most important points from the Guidelines that may be applied in general health and medical settings. For some of the points, we have added our interpretation of additional scientific information that is relevant to a clinical audience. Some solutions need to be implemented outside of our health systems, such as through community awareness, promotion of lifelong exercise, and provision of safe accessible environments. Following the Guidelines structure, which highlights the importance of tailored intervention rather than a detailed assessment, this article first discusses effective interventions and thereafter addresses assessment.