Personalised programmes to prevent falls in older people may make no difference, according to a comprehensive review of the evidence.

A Cochrane review that included 110 randomised controlled trials of almost 49,000 older people found that that multifactorial programmes tailored to individual falls risk are no better than simple falls advice or education.

Simply encouraging exercise may have the most benefit, they added.

Researchers from Exeter University found multifactorial programmes only slightly reduced the rate of falls or risk of recurrent falls when compared to usual medical care.

And compared with exercise, it is unclear whether they reduce the rate of falls or the risk of falling again at all, they reported.

Falls are one of the most common causes of injury and death in older people with around one in three people aged over 65 experiences at least one fall each year, they noted.

Multifactorial programmes combine fall prevention approaches tailored to an individual’s levels of risk and can include exercise, education, counselling, and medication review and home hazard removals.

The researchers also looked at multi-component treatments, which combine a range of approaches, but where everyone gets the same intervention.

Here they also found little or no benefit in how often people fall when compared to usual medical care, exercise or falls prevention education.

Co-lead Dr Lianne Wood, Bateman family chair in peripheral neuropathy at University of Exeter Medical School, said: ‘In an ageing society, effectively preventing falls can save lives and help people live healthier lives for longer.

‘Our health services operate on limited funding, and we need to ensure we’re being guided by the best evidence to prevent falls.’

Dr Cynthia Swarnalatha, co-lead of the review and also at University of Exeter Medical School, added the team were surprised to find that many of the more complex programmes did not measure up.

‘Providing effective education and focussing on encouraging the uptake of exercise are more simple approaches, and we also found them to have potentially the most benefit in falls prevention.’

The team added that the results show how much is still to learn about how and why falls happen in the first place.

They are beginning a major study to understand why people have unstable walking and are at higher risk of falls to help design better prevention programmes.

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Tailored falls prevention programmes no better than offering advice and exercise