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      World guidelines for falls prevention and management for older adults: a global initiative

      review-article
      , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , the Task Force on Global Guidelines for Falls in Older Adults
      Age and Ageing
      Oxford University Press
      falls, injury, aged, guidelines, recommendations, clinical practice, world, global, consensus, older people

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. Current guidelines are inconsistent, with no up-to-date, globally applicable ones present.

          Objectives

          to create a set of evidence- and expert consensus-based falls prevention and management recommendations applicable to older adults for use by healthcare and other professionals that consider: (i) a person-centred approach that includes the perspectives of older adults with lived experience, caregivers and other stakeholders; (ii) gaps in previous guidelines; (iii) recent developments in e-health and (iv) implementation across locations with limited access to resources such as low- and middle-income countries.

          Methods

          a steering committee and a worldwide multidisciplinary group of experts and stakeholders, including older adults, were assembled. Geriatrics and gerontological societies were represented. Using a modified Delphi process, recommendations from 11 topic-specific working groups (WGs), 10 ad-hoc WGs and a WG dealing with the perspectives of older adults were reviewed and refined. The final recommendations were determined by voting.

          Recommendations

          all older adults should be advised on falls prevention and physical activity. Opportunistic case finding for falls risk is recommended for community-dwelling older adults. Those considered at high risk should be offered a comprehensive multifactorial falls risk assessment with a view to co-design and implement personalised multidomain interventions. Other recommendations cover details of assessment and intervention components and combinations, and recommendations for specific settings and populations.

          Conclusions

          the core set of recommendations provided will require flexible implementation strategies that consider both local context and resources.

          Related collections

          Most cited references273

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          GRADE: an emerging consensus on rating quality of evidence and strength of recommendations.

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            Sarcopenia: revised European consensus on definition and diagnosis

            Abstract Background in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.
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              Frailty in Older Adults: Evidence for a Phenotype

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                Author and article information

                Contributors
                Journal
                Age Ageing
                Age Ageing
                ageing
                Age and Ageing
                Oxford University Press
                0002-0729
                1468-2834
                September 2022
                30 September 2022
                30 September 2022
                : 51
                : 9
                : afac205
                Affiliations
                Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute , London, ON, Canada
                Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario , London, ON, Canada
                Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario , London, ON, Canada
                Amsterdam UMC location University of Amsterdam , Internal Medicine, Section of Geriatric Medicine, Amsterdam, The Netherlands
                Amsterdam Public Health, Aging and Later Life , Amsterdam, The Netherlands
                Population Health Sciences, Faculty of Life Sciences and Medicine, King's College London , London, UK
                Department of Internal Medicine and Paediatrics, Section of Geriatrics, Faculty of Medicine and Health Sciences, Ghent University , Ghent, Belgium
                Centre for Innovation in Medical Engineering (CIME), Faculty of Engineering, University of Malaya , Kuala Lumpur 50603, Malaysia
                Department of Medicine, Faculty of Medicine, University of Malaya , Kuala Lumpur 50603, Malaysia
                Department of Geriatric Medicine, Odense University Hospital , Odense, Denmark
                Geriatric Research Unit, Department of Clinical Research, University of Southern Denmark , Odense, Denmark
                Department of Geriatric Medicine, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City, Mexico
                Department of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan; Veterans Administration Ann Arbor Healthcare System Geriatrics Research Education Clinical Center , Ann Arbor, MI, USA
                Department of Clinical Gerontology and Geriatric Rehabilitation, Robert Bosch Hospital , Stuttgart, Germany
                Department of Geriatrics, Montpellier University hospital and MUSE , Montpellier, France
                Department of Medical Gerontology Trinity College Dublin and Mercers Institute for Successful Ageing , St James’s Hospital, Dublin, Ireland
                John Walsh Centre for Rehabilitation Research , Northern Sydney Local Health District and Faculty of Medicine and Health, University of Sydney. Department of Medicine (Neurology) and Neuroscience and Mental Health, Sydney, NSW, Australia
                Department of Medicine (Neurology), Neuroscience and Mental Health Institute, University of Alberta , Edmonton, AB, Canada
                Sydney School of Health Sciences, Faculty of Medicine & Health, The University of Sydney , Sydney, Australia
                Falls, Balance and Injury Research Centre, Neuroscience Research Australia, University of New South Wales , Sydney, NSW, Australia
                Prince of Wales Clinical School, Medicine, University of New South Wales , Sydney, NSW, Australia
                Falls , Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, NSW, Australia; School of Population Health, University of New South Wales, Kensington, NSW, Australia
                National Centre for Chronic and Noncommunicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention , Beijing, China
                Research Institute of the McGill University HealthCentre , Montreal, Quebec, Canada
                Flinders Health and Medical Research Institute , Flinders University, Adelaide, SA, Australia
                Friedrich-Alexander-University Erlangen-Nürnberg , Institute for Biomedicine of Aging, Nürnberg, Germany
                Multicampus Program in Geriatric Medicine and Gerontology, David Geffen School of Medicine at UCLA and Veterans Affairs Greater Los Angeles Healthcare System , Los Angeles, CA, USA
                Research Group on Geriatrics and Gerontology, International Association of Gerontology and Geriatrics Collaborative Center, University Caldas , Manizales, Colombia
                Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center , Tel Aviv, Israel
                Department of Physical Therapy, Sackler Faculty of Medicine, and Sagol School of Neuroscience, Tel Aviv University , Tel Aviv, Israel
                Department of Orthopaedic Surgery, Rush Alzheimer's Disease Center, Rush University Medical Center , Chicago, IL, USA
                Brenda Strafford Centre on Aging, O’BrienInstitute for Public Health , Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
                School of Physical Therapy, Faculty of Health Sciences , Elborn College, University of Western Ontario, London, ON, Canada
                Ageing Biology Unit, Hospital Italiano de Buenos Aires , Buenos Aires, Argentina
                Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute , London, ON, Canada
                Department of Medical Gerontology Trinity College Dublin and Mercers Institute for Successful Ageing , St James’s Hospital, Dublin, Ireland
                Faculty of Health and Life Sciences, Mireille Gillings Professor of Health Innovation, Medical School Building , Exeter, England, UK
                Brigham and Women's Hospital , Boston, MA, USA
                Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Harvard Medical School , Boston, MA, USA
                Djavad Mowafaghian Centre for Brain Health, Center for Hip Health and Mobility , Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, BC, Canada
                School of Medicine, University of Nottingham , Nottingham, England, UK
                Falls, Balance and Injury Research Centre, Neuroscience Research Australia , Sydney, NSW, Australia
                School of Public Health and Community Medicine, University of New South Wales , Sydney, NSW, Australia
                Department of Pharmacy, Faculty of Pharmacy, McGill University Health Center, Université de Montréal , Montreal, QC, Canada
                University College London , London, England, UK
                Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven , Leuven, Belgium
                Department of Geriatric Medicine, University Hospitals Leuven , Leuven, Belgium
                Geriatric Medicine & Neurology Fellowship , Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”. Mexico City, Mexico
                Geriatric Medicine Program, Tecnologico de Monterrey , School of Medicine and Health Sciences. Monterrey, Nuevo León, Mexico
                Healthscope and Academic and Research Collaborative in Health (ARCH) , La Trobe University, Australia
                Department of Rehabilitation Sciences, Neurorehabilitation Research Group (eNRGy), KU Leuven , Leuven, Belgium
                Master’s and Doctoral programs in Physical Therapy, Universidade Cidade de Sao Paulo (UNICID) , Sao Paulo, Brazil
                Gait and Brain Lab, Parkwood Institute, Lawson Health Research Institute , London, ON, Canada
                Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario , London, ON, Canada
                Mackay Institute of Research and Innovation, Mackay Hospital and Health Service , Mackay, QLD, Australia
                Western Health, University of Melbourne , Parkville, Melbourne, VIC, Australia
                Australian Institute for Musculoskeletal Science (AIMSS) , The University of Melbourne and Western Health, St Albans, VIC, Australia
                Melbourne School of Health Sciences The University of Melbourne , Parkville, Australia
                Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh , Pittsburgh, PA, USA
                Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District , Sydney, Australia
                School of Health and Life Sciences, Research Centre for Health (ReaCH) , Glasgow Caledonian University, Cowcaddens Road, Glasgow, Scotland, UK
                Department of Occupational Therapy, Manipal College of Health Professions , Manipal Academy of Higher Education, Manipal, Karnataka, India
                Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario , London, ON, Canada
                Schulich Interfaculty Program in Public Health, Schulich School of Medicine & Dentistry, University of Western Ontario , London, ON, Canada
                Program in Occupational Therapy, School of Medicine, Washington University in St. Louis , St. Louis, MO, USA
                School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester , Manchester, England, UK
                Manchester University NHS Foundation Trust , Manchester M13 9WL, UK
                Division of Geriatrics and Palliative Medicine, Department of Medicine , Jacobs School of Medicine & Biomedical Sciences, University of Buffalo; Research Service, Veterans Affairs Western New York Healthcare System, Buffalo, New York, USA
                Department of Human-Centred Design, Faculty of Industrial Design Engineering, Delft University of Technology , Delft, The Netherlands
                Section of Geriatric Medicine, Department of Internal Medicine, Erasmus University Medical Center , Rotterdam, The Netherlands
                Division of Geriatrics, Department of Medicine, Albert Einstein College of Medicine , Bronx, New York, USA
                Department of Neurology, Albert Einstein College of Medicine , Bronx, NY, USA
                Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery , KU Leuven, Leuven, Belgium
                Faculty of Medicine and Life Sciences, Hasselt University , Hasselt, Belgium
                Li Ka Shing Knowledge Institute, St. Michael’s Hospital , Toronto, ON, Canada
                Department of Medicine, University of Toronto , Toronto, ON, Canada
                Department of Geriatric Medicine, The British Geriatrics Society, Nottingham University Hospitals NHS Trust , Nottingham, England, UK
                Author notes
                Address correspondence to: Manuel Montero-Odasso. Email: mmontero@ 123456uwo.ca

                Co-principal authors.

                Acknowledgement of collaborative authors: The members of the Task Force on Global Guidelines for Falls in Older Adults are listed in Appendix 4a, available in Age and Ageing online. Devinder Kaur Ajit Singh, Sara G. Aguilar-Navarro, Edgar Aguilera Caona, Neil B. Alexander, Natalie Allen, Cedric Anweiller, Alberto Avila-Funes, Renato Barbosa Santos, Francis Batchelor, Clemens Becker, Marla Beauchamp, Canan Birimoglu, Hubert Blain, Kayla Bohlke, Robert Bourke, Christina Alonzo Bouzòn, Stephanie Bridenbaugh, Patricio Gabriel Buendia, Ian Cameron, Richard Camicioli, Colleen Canning, Carlos Alberto Cano-Gutierrez, Juan Carlos Carbajal, Daniela Cristina Carvalho de Abreu, Alvaro Casas-Herrero, Alejandro Ceriani, Matteo Cesari, Lorenzo Chiari, Lindy Clemson, Jacqueline Close, Luis Manuel Cornejo Alemǻn, Rik Dawson, Kim Delbaere, Paul Doody, Sabestina Dsouza, Leilei Duan, Gustavo Duque, Suzanne Dyer, Toby Ellmers, Nicola Fairhall, Luigi Ferruci, Ellen Freiberger, James Frith, Homero Gac Espinola, David A. Ganz, Fabiana Giber, José Fernando Gómez, Luis Miguel Gutiérrez-Robledo, Sirpa Hartikainen, Jeffrey Hausdorff, David B. Hogan, Chek Hooi Wong, Simon Howe, Susan Hunter, Javier Perez Jara, Ricardo Jauregui, Anton Jellema, Suen Jenni, Ditte Jepson, Sebastiana Kalula, Nellie Kamkar, Devinder Kaur Ajit Singh, Rose Anne Kenny, Ngaire Kerse, Olive Kobusingye, Reto Kressig, Wing Kwok, Sallie Lamb, Nancy Latham, Mei Ling Lim, Lewis Lipsitz, Teresa Liu-Ambrose, Pip Logan, Stephen Lord, Roberto Alves Lourenço, Kenneth Madden, Louise Mallet, Pedro Marín-Larraín, David R. Marsh, Finbarr C. Martin, Diego Martínez Padilla, Tahir Masud, Sumaiyah Mat, Lisa McGarrigle, Bill McIlroy, Felipe Melgar-Cuellar, Jasmine Menant, Koen Milisen, Alberto Mimenza, Rogelio Moctezuma-Gallegos, Manuel Montero-Odasso, Meg E. Morris, Irfan Muneeb, Hossein Negahban, Alice Nieuwboer, Mireille Norris, Giulia Ogliari, Juliana Oliveira, José F. Parodi, Sergio Perez, Monica Perracini, Mirko Petrovic, José Ernesto Picado Ovares, Frederico Pieruccini-Faria, Alison Pighills, Marina Pinheiro, Eveline Poelgeest, Xinia Ramirez Ulate, Katie Robinson, Jesper Ryg, Cathy Said, Ryota Sakurai, Marcelo Schapira, Ervin Sejdic, Lotta J. Seppala, Aldo Sgaravatti, Cathie Sherrington, Dawn Skelton, Yu Song, Mark Speechley, Susan Stark, Munira Sultana, Anisha Suri, Maw Pin Tan, Morag Taylor, Katja Thomsen, Anne Tiedemann, Susana Lucia Tito, Chris Todd, Bruce Troen, Tischa Van der Cammen, Nathalie Van der Velde, Joe Verghese, Ellen Vlaeyen, Jennifer Watt, Ana-Karim Welmer, Chang Won Won, G.A. Rixt Zijlstra

                Author information
                https://orcid.org/0000-0002-5796-2361
                https://orcid.org/0000-0002-6911-3498
                https://orcid.org/0000-0002-8641-3062
                https://orcid.org/0000-0002-0177-2470
                https://orcid.org/0000-0001-8126-0637
                https://orcid.org/0000-0001-9230-1246
                https://orcid.org/0000-0001-9331-3820
                Article
                afac205
                10.1093/ageing/afac205
                9523684
                36178003
                6380576c-e815-456c-8db4-463830f601b8
                © The Author(s) 2022. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 15 August 2022
                : 26 August 2022
                : 26 August 2022
                Page count
                Pages: 00
                Funding
                Funded by: funder-nameCIHR Planning and Dissemination Grant from the Institute of Ageing;
                Award ID: RN476173-478689
                Funded by: funder-nameSt. Joseph Foundation, London, Ontario, Canada;
                Award ID: 74531
                Categories
                Guideline
                AcademicSubjects/MED00280
                ageing/15
                ageing/10
                ageing/5

                Geriatric medicine
                falls,injury,aged,guidelines,recommendations,clinical practice,world,global,consensus,older people
                Geriatric medicine
                falls, injury, aged, guidelines, recommendations, clinical practice, world, global, consensus, older people

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