Level 1: Likely reliable evidence and
Level 2: Mid-level evidence
A Cochrane review examined 111 randomized trials evaluating interventions to prevent falls in community-dwelling older adults (Cochrane Database Syst Rev. 2009;[2]:CD007146). There was strong evidence for the effectiveness of individually prescribed, multicomponent home exercise in a meta-analysis of four trials with 666 adults. Also effective were group tai chi and group training to improve gait, balance, and functional mobility in meta-analyses of moderate-quality trials. Group multicomponent exercise and multifactorial interventions were also as- sociated with significant reductions in falls, but these findings were limited by significant het- erogeneity in the meta-analyses. A number of interventions, including surgical procedures (cataract surgery, pacemaker implantation), medical-prescription modification (including gradual withdrawal of psychotropic drugs), and home-safety interventions, appeared effective in individual trials.