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At that time, the USPSTF also recommended vitamin D supplementation to prevent falls (B recommendation), based on previous evidence that found a reduction in the number of persons experiencing a fall. Importance. However, many interventions with insufficient evidence to support their use to prevent falls have other arguments that support their use.Studies are needed on the clinical validation of primary care tools to identify older adults at increased risk for falls. However, as people get older, they are more likely to fall over. A study of annual high-dose vitamin D supplementation showed an increase in falls. The current review excluded studies considered in the previous review that enrolled persons with vitamin D deficiency or insufficiency because, on further consideration, vitamin D supplementation in these examined additional fall-related outcomes, including incident falls (in addition to the number of persons experiencing a fall, which was considered in the previous review). With this revised scope of review, as well as newer evidence from trials reporting no benefit, the USPSTF found that vitamin D supplementation has no benefit in falls prevention in community-dwelling older adults not known to have vitamin D deficiency or insufficiency. Interventions that target health conditions that may affect falls risk but have other reasons for assessment and treatment (such as visual impairment or neurologic disorders) were considered to be out of scope for the current review. Pooled analyses revealed statistically significant reductions in 1 fall-related outcome (number of falls) but not others (eg, number of persons experiencing a fall). The most common exercise component was gait, balance, and functional training (17 trials), followed by resistance training (13 trials), flexibility (8 trials), and endurance training (5 trials). Additional research is needed on the effectiveness of interventions in different age groups, in particular adults older than 85 years. For additional details on multifactorial interventions reviewed by the USPSTF, please see the full evidence report.The following single interventions lack sufficient evidence for or against their use to prevent falls in community-dwelling older adults when offered alone and not in the context of a multifactorial intervention: environmental modification, medication management, psychological interventions, and combination interventions not customized to an individual risk profile.Fractures are an important injury associated with falls, and the USPSTF has issued 2 related recommendation statements on the prevention of fractures. Thus, the USPSTF now recommends against vitamin D supplementation for the prevention of falls in community-dwelling older adults.The National Institute on Aging outlines similar interventions for the prevention of falls: exercise for strength and balance, monitoring for environmental hazards, regular medical care to ensure optimized hearing and vision, and medication management.The US Preventive Services Task Force (USPSTF) members include the following individuals: David C. Grossman, MD, MPH (Kaiser Permanente Washington Health Research Institute, Seattle); Susan J. Curry, PhD (University of Iowa, Iowa City); Douglas K. Owens, MD, MS (Veterans Affairs Palo Alto Health Care System, Palo Alto, California, and Stanford University, Stanford, California); Michael J. Barry, MD (Harvard Medical School, Boston, Massachusetts); Aaron B. Caughey, MD, PhD (Oregon Health & Science University, Portland;) Karina W. Davidson, PhD, MASc (Columbia University, New York, New York); Chyke A. Doubeni, MD, MPH (University of Pennsylvania, Philadelphia); John W. Epling Jr, MD, MSEd (Virginia Tech Carilion School of Medicine, Roanoke); Alex R. Kemper, MD, MPH, MS (Nationwide Children’s Hospital, Columbus, Ohio); Alex H. Krist, MD, MPH (Fairfax Family Practice Residency, Fairfax, Virginia, and Virginia Commonwealth University, Richmond); Martha Kubik, PhD, RN (Temple University, Philadelphia, Pennsylvania); Seth Landefeld, MD (University of Alabama at Birmingham); Carol M. Mangione, MD, MSPH; Michael Silverstein, MD, MPH (Boston University, Boston, Massachusetts); Melissa A. Simon, MD, MPH (Northwestern University, Evanston, Illinois); Chien-Wen Tseng, MD, MPH, MSEE (University of Hawaii, Honolulu, and Pacific Health Research and Education Institute, Honolulu, Hawaii).AHRQ and the US Department of Health and Human Services cannot endorse, or appear to endorse, derivative or excerpted materials, and they cannot be held liable for the content or use of adapted products that are incorporated on other Web sites. Falls can become recurrent and result in injuries including head injuries and hip fractures. Resources for nursing professionals on the prevention, treatment and management of falls in older people

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