Over the past 50 years we have transitioned from accepting falls as an inevitable consequence of ageing to something that can and should be prevented. Numerous studies have elucidated the contributors to falls and how to assess a person’s risk of falling. There are many effective approaches to preventing falls in older people including those with cognitive and physical impairments. Exercise is the most tried and tested approach with good evidence that moderate to high intensity balance training is an effective fall prevention strategy. Other successful single modality interventions include enhanced podiatry, home safety interventions, expedited cataract extraction, cardiac pacing for people with carotid sinus hypersensitivity and vitamin D supplementation in people living in care homes. Multiple interventions (everyone receives the same intervention package) and multifactorial interventions (interventions tailored to identified risk factors) are effective particularly in high-risk populations. In more recent years we have seen the emergence of new technologies such as devices and software programs that can offer low-cost interventions which may be more sustainable than our traditional time- and resource-limited approach to prevention. There is still more to be done and a translational focus is needed to ensure that effective interventions are scaled up and delivered to more people while at the same time maximising adherence and maintaining the fidelity of the interventions.

中文翻译：

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老年人跌倒预防：过去、现在和未来

在过去的 50 年里，我们已经从接受跌倒作为衰老不可避免的结果转变为可以而且应该预防的事情。许多研究已经阐明了跌倒的原因以及如何评估一个人跌倒的风险。有许多有效的方法可以预防老年人跌倒，包括那些有认知和身体障碍的人。运动是最久经考验的方法，有充分的证据表明中高强度平衡训练是一种有效的跌倒预防策略。其他成功的单一方式干预措施包括增强足病学、家庭安全干预、加速白内障摘除、颈动脉窦超敏反应患者的心脏起搏和居住在疗养院的人补充维生素 D。多重干预（每个人都接受相同的干预包）和多因素干预（针对确定的风险因素量身定制的干预）在高风险人群中特别有效。近年来，我们看到了新技术的出现，例如可以提供低成本干预措施的设备和软件程序，这些干预措施可能比我们传统的时间和资源有限的预防方法更具可持续性。还有更多工作要做，需要重点关注转化，以确保扩大有效干预措施并将其提供给更多人，同时最大限度地提高依从性并保持干预措施的准确性。近年来，我们看到了新技术的出现，例如可以提供低成本干预措施的设备和软件程序，这些干预措施可能比我们传统的时间和资源有限的预防方法更具可持续性。还有更多工作要做，需要重点关注转化，以确保扩大有效干预措施并将其提供给更多人，同时最大限度地提高依从性并保持干预措施的准确性。近年来，我们看到了新技术的出现，例如可以提供低成本干预措施的设备和软件程序，这些干预措施可能比我们传统的时间和资源有限的预防方法更具可持续性。还有更多工作要做，需要重点关注转化，以确保扩大有效干预措施并将其提供给更多人，同时最大限度地提高依从性并保持干预措施的准确性。