FALL PREVENTION IN OLDER ADULTS: RISK ASSESSMENT AND INTERPROFESSIONAL MANAGEMENT
Faculty:
L. Austin Fredrickson, MD, FACP
L. Austin Fredrickson is an Associate Professor of Internal Medicine at Northeast Ohio Medical University, where he serves as core faculty and teaches diagnostics, therapeutics, clinical skills, and health humanities. He is board-certified in general internal medicine and practices rural primary care.
Kristina (Tia) Neu, RN
Kristina (Tia) Neu is a licensed Registered Nurse and author currently developing in-service training for healthcare professionals. She is a National Board-Certified Health & Wellness and Lifestyle Medicine Coach. Her work experience includes several areas of the healthcare profession, such as psychiatric nursing, medical nursing, motivational health coaching, chronic case management, dental hygiene, cardiac technician, surgical technician, and clinical director of a Clinically Integrated Network (CIN).
Liz Fredrickson, PharmD, BCPS
Liz Fredrickson, PharmD, BCPS, is an Associate Professor of Pharmacy Practice and Pharmaceutical Sciences at the Northeast Ohio Medical University (NEOMED) College of Pharmacy, where she is course director of the Parenteral Products and Basic Pharmaceutics Lab courses.
Pamela Sardo, PharmD, BS
Pamela Sardo, PharmD, BS, is a freelance medical writer and licensed pharmacist. She is the founder and principal at Sardo Solutions in Texas. Pam received her BS from the University of Connecticut and her PharmD from the University of Rhode Island. Pam’s career spans many years in retail, clinics, hospitals, long-term care, Veterans Affairs, and managed health care responsibilities across a broad range of therapeutic classes and disease states.
Abstract
Falls remain a leading cause of injury, functional decline, hospitalization, and death in older adults, with risk influenced by prior falls, gait and balance impairment, chronic disease burden, vision problems, orthostatic symptoms, medication exposure, and environmental hazards. This activity reviews the epidemiology and clinical burden of falls. It discusses recommendations from the U.S. Preventive Services Task Force (USPSTF), American Geriatrics Society (AGS), and Centers for Disease Control and Prevention (CDC). Guidance from these entities varies, but they review targeted interventions for older adults in community-dwelling settings and provide specific recommendations. Interventions may include medication management, vision screenings, referrals to fall-prevention programs, and exercise regimens. Distinctions between community-dwelling older adults and care-facility populations are highlighted throughout, with attention to the complementary roles of healthcare team members in implementing evidence-based fall-prevention strategies.
Accreditation Statements
In support of improving patient care, RxCe.com LLC is jointly accredited by the Accreditation CouncilTM for Continuing Medical Education (ACCME®), the Accreditation Council for Pharmacy Education (ACPE®), and the American Nurses Credentialing Center (ANCC®), to provide continuing education for the healthcare team.
This activity was planned by and for the healthcare team, and learners will receive 2 Interprofessional Continuing Education (IPCE) credits for learning and change.
Joint Universal Activity Number: The Joint Accreditation Universal Activity Numbers assigned to this activity are as follows:
Pharmacists: JA4008424-0000-26-068-H01-P
Pharmacy Technicians: JA4008424-0000-26-068-H01-T
Credits: 2 contact hour(s) (0.2 CEU(s)) of continuing education credit.
Credit Types:
IPCE Credits - 2 Credits
AAPA Category 1 Credit™️ - 2 Credits
AMA PRA Category 1 Credit™️ - 2 Credits
Pharmacy - 2 Credits
Type of Activity: Application
Media: Computer-Based Training (i.e., online courses)
Estimated time to complete activity: 2 contact hour(s) (0.2 CEU(s)), including Activity Pre-Test, Post-Test, and Activity Evaluation.
Release Date: May 18, 2026 Expiration Date: May 18, 2029
Target Audience: This educational activity is for Physicians, Physician Assistants, Pharmacists, and Pharmacy Technicians
How to Earn Credit: From May 18, 2026, through May 18, 2029, participants must:
Read the “learning objectives” and “author and planning team disclosures;”
Take the “Educational Activity Pre-Test;”
Study the section entitled “Educational Activity;” and
Complete the Educational Activity Post-Test and Activity Evaluation. The Educational Activity Post-Test will be graded automatically. Following successful completion of the Educational Activity Post-Test with a score of 70% or higher, a statement of participation will be made available immediately. (No partial credit will be given.)
CE and CME Credits: Credits for this course will be uploaded to CPE Monitor® for pharmacists and pharmacy technicians. Physicians may receive AMA PRA Category 1 Credit™️ and use these credits toward Maintenance of Certification (MOC) requirements. Physician Assistants may earn AAPA Category 1 CME credits, reportable through PA Portfolio. All learners shall verify their individual licensing board’s specific requirements and eligibility criteria.
Statement of Need
Falls in adults aged 65 years and older remain a major public health and clinical problem. The USPSTF and CDC data show that falls are common among community-dwelling older adults and are associated with substantial injury burden, emergency visits, hospitalization, and death, with the highest and fastest-rising mortality burden among adults aged 85 years and older. Interprofessional team members also need actionable guidance on medication-related fall risk, including application of the 2023 AGS Beers Criteria, STOPP/START version 3, CNS-active polypharmacy concerns, and deprescribing strategies after a fall or positive screen.
Learning Objectives: Upon completion of this educational activity, participants should be able to:
Describe the epidemiology and clinical burden of falls in older adults across community and residential care settings
Identify older adults at an increased risk for falls using evidence-based screening and assessment strategies
Evaluate modifiable risk factors for falls, including medication, environmental, and comorbidity-related contributors
Develop individualized, interprofessional fall prevention plans that incorporate interprofessional collaboration
Disclosures
The following individuals were involved in planning, developing, and/or authoring this activity: L. Austin Fredrickson, MD, FACP; Kristina (Tia) Neu, RN; Liz Fredrickson, PharmD, BCPS; and Pamela Sardo, PharmD, BS. None of the individuals involved in developing this activity has a conflict of interest or financial relationships related to the subject matter. There are no financial relationships or commercial or financial support relevant to this activity to report or disclose by RxCe.com or any of the individuals involved in the development of this activity.
This activity was outlined and planned by the named faculty above. Thereafter, artificial intelligence tools Claude Opus 4.7 and ChatGPT 5.4 were used to generate the first draft of this activity. Finally, the faculty reviewed and edited the content of this activity in full. This accredited provider and its faculty are in full control of and responsible for the content, and all content complies with the Standards for Integrity and Independence, including removal of any commercial bias or promotional language. RxCe.com faculty confirmed that the AI-generated content is evidence-based, presents a balanced view of diagnostic and treatment options, and does not reflect the interests of ineligible companies nor promote specific products or brands.
© RxCe.com LLC 2026: All rights reserved. No reproduction of all or part of any content herein is allowed without the prior, written permission of RxCe.com LLC.
Educational Activity Pre-Test
Which statement best describes the epidemiology and clinical burden of falls in older adults?
Falls are rare in adults over age 65 and rarely result in injury in residential care settings
Falls are a major cause of injury and loss of independence in adults over age 65 in community or residential care settings
Falls primarily affect hospitalized older patients, but do not impact quality scores
Falls are usually caused by a single acute illness, or improper accessories, e.g., glasses that do not fit properly
Which screening approach is most appropriate for identifying older adults at increased risk for falls?
Perform annual screening for history of falls, balance difficulty, and fear of falling
Due to appointment time constraints, ask whether the patient has fallen in the past 24 hours
Use only a visual acuity test to determine fall risk in community-based patients
Screen only long-term care patients since nursing shortages may not permit frequent bedside monitoring
Which interprofessional plan best addresses modifiable fall risk factors for an older adult?
Refer all older patients to physical therapy because medications cannot be modified
Require each older patient to focus on strength exercises with the objective of increasing arm strength
Complete medication review, address environmental hazards, and coordinate interprofessional collaboration
Recommend that each older patient undergo a podiatry appointment to check for ill-fitting footwear
Educational Activity
Fall Prevention in Older Adults:
Risk Assessment and Interprofessional Management
Introduction
Falls remain a leading cause of injury-related morbidity and mortality among older adults, resulting in significant clinical, functional, and economic burdens. Fall risk is multifactorial, driven by medication use, environmental hazards, and physical or mental functional decline. Risk also increases with advancing age and a prior history of falls. The U.S. Preventive Services Task Force (USPSTF), the American Geriatrics Society (AGS), and the Centers for Disease Control and Prevention (CDC) provide guidance on fall prevention that focuses on modifiable risk factors and targeted interventions, including medication management, vision screenings, referrals to fall-prevention programs, and exercise regimens for older adults in community-dwelling settings.
This continuing activity reviews the epidemiology and clinical burden of falls, describes validated screening and assessment approaches to identify individuals at increased risk, and highlights strategies to address modifiable contributors, including medication-related risks. Updated recommendations from the American Geriatrics Society are also discussed, with an emphasis on developing individualized, interprofessional fall-prevention plans that integrate physician–pharmacist collaboration across care settings.
Epidemiology and Burden of Falls in Older Adults
Falls are a leading cause of death, injury, and loss of functional independence in adults aged 65 years and older.1 In 2018, approximately 27.5% of community-dwelling older adults reported at least one fall in the previous year, and 10.2% reported a fall-related injury.2 The CDC’s surveillance estimated that falls among older adults resulted in approximately 3 million emergency department visits, more than 950,000 hospitalizations or transfers, and about 32,000 deaths in 2018.3 The burden and impact of falls on older adults continues. to persist: In 2021, the CDC reported 38,742 deaths from fall-related injuries.2
Falls also result in an economic burden on society. In 2020, the estimated U.S. healthcare expenditure for nonfatal falls was $80 billion, with the majority of costs borne by Medicare.4 Beyond direct medical costs, falls often lead to long-term disability, reduced quality of life, and increased caregiver burden, further highlighting their societal impact.
Risk Factors for Falls
Among older adults, falls are typically multifactorial, resulting from a combination of modifiable and non-modifiable risk factors.2 The 2024 USPSTF recommendation identified several key contributors, including increased age, cognitive and sensory deficits, and acute or chronic medical conditions. Other evidence-based sources highlight prior falls, gait and balance impairment, mobility limitation, muscle weakness, medication burden, visual problems, postural hypotension, and alcohol or drug use may also contribute.2 Certain environmental and occupational hazards, home or neighborhood features, and unsafe footwear have also been identified as risk factors.5-8
Clinically, a fall should not be viewed as an isolated event. Even in the absence of serious injury, a fall may signal previously unrecognized impairments in mobility, medication-related adverse effects, orthostatic hypotension, environmental hazards, or other conditions.2,5 The USPSTF evidence framework further emphasizes a range of clinically meaningful outcomes related to falls, including the following:1
total falls
injurious falls
fractures
hospitalization
institutionalization
disability
potential harms of interventions
This broader perspective reinforces the importance of comprehensive risk assessment and targeted prevention strategies.
Age
Aging is a non-modifiable risk factor for falling. The risk of falling increases with advancing age, as seen in Table 1 below.2
Table 1
Risk of Falls Stratified by Age2
| Age (Years) | Percentage Reporting Fall |
| 65-75 | 26% |
| 75-84 | 29% |
| ≥85 | 34% |
Persons aged 85 years or older had the highest proportion of fall-related injuries and deaths.2 The death rate from falls in this age group is also increasing at a greater percentage than the younger age groups.2
Physical Limitations
Physical limitations or frailty are modifiable risk factors for falls. Studies have identified gait and balance impairment, mobility limitation, and muscle weakness as core predictors of future falls.1,2,7 Frailty and chronic disease burden also increase a person’s fall risk by reducing the individual’s physiologic reserve, or the resilience or ability to withstand stress.2,9
Visual Impairment
Visual impairment is another important modifiable risk factor.10 In a prospective cohort study of 329 adults aged 65 years or older awaiting bilateral cataract surgery, patients were scheduled for an initial surgery on the eye with the poorer vision. The initial surgery (first-eye surgery) was associated with a 33% reduction in fall incidences.10 However, a large change in the patient’s eyeglass prescription following the initial surgery was associated with an increased risk of falls.10 To avoid this potential for increased falls, postoperative follow-up on changes to the eye lens is needed.10
Environmental Hazards
Environmental hazards often coincide with physical vulnerabilities, increasing the risk of falls.7,12 These hazards include flooring (loose carpeting, wet floors, uneven surfaces), bathroom facilities with inappropriate toilet and wash basin heights or lacking handrails, poorly designed stairs and steps, poor lighting, clutter, and other room furnishings that impede accessibility.5 These hazards may be addressed by improving a patient’s environmental setting.
Cognitive Impairment
Cognitive impairment also contributes to risk and requires individualized assessment.2,8 Annually, approximately 60% of older adults with cognitive impairment and dementia will suffer a fall.8 This is 2 to 3 times greater than the fall rate of cognitively healthy older adults, or the general population of community-dwelling adults aged 65 years or older, which is ~28.7%.1,8
Medication-related Fall Risk
Medication use can increase the risk of falls, and this becomes greater with polydrug use.13,14 A study of 6,959 community-dwelling older Americans found that 67.2% used at least one psychoactive medication from seven fall-risk classes, and about one-third used two or more psychoactive medications.13 A 2026 cross-sectional study of 211,783 long-stay nursing home residents identified the high prevalence of CNS polypharmacy, defined as concurrent use of three or more CNS-active medications identified in the Beers Criteria.14,15
Different classes of medications are associated with an increased risk of falls. One study found that 15.5% of fall patients who took sedative-hypnotic drugs had higher fracture rates.16 Central nervous system drugs can lead to orthostatic hypotension, and this sudden drop in blood pressure can lead to falls and injury.9,15 Antihypertensives are also associated with an increased risk of falls.9 These drugs, as with other drugs, require an individualized approach that balances the antihypertensive medication’s cardiovascular benefits with the risk of serious falls. This individualized approach considers the patient’s frailty and morbidities (e.g., dementia).9
Table 2
Medications that May Contribute to Falls9,13-17
| Medication Class | Mechanism Contributing to Falls | Common Examples | Clinical Pearls / Actions |
| Benzodiazepines | Sedation, impaired coordination, cognitive slowing | Diazepam, Lorazepam, Alprazolam | Avoid when possible; taper slowly; high fracture risk |
| Non-benzodiazepine hypnotics (Z-drugs) | Sedation, dizziness, impaired balance | Zolpidem, Eszopiclone, Zaleplon | Similar fall risk to benzos; often underestimated |
| Antidepressants (esp. TCAs, SSRIs) | Orthostasis, sedation, hyponatremia | Amitriptyline, Paroxetine, Sertraline, Citalopram | TCAs are the highest risk; SSRIs still increase falls |
/// Antipsychotics | /// Sedation, extrapyramidal effects, orthostasis | /// Quetiapine, Risperidone, Olanzapine | /// Use the lowest dose; reassess need regularly |
| Opioids | Sedation, dizziness, impaired cognition | Oxycodone, Hydrocodone, Morphine | Highest risk when initiating or dose increasing |
| Anticholinergics | Confusion, blurred vision, sedation | Diphenhydramine, Oxybutynin, Hydroxyzine | Cumulative burden matters (anticholinergic load) |
| Antihypertensives | Orthostatic hypotension, dizziness | Amlodipine, Lisinopril, Metoprolol | Individualize BP goals; monitor standing BP |
| Diuretics | Volume depletion, electrolyte imbalance | Furosemide, Hydrochlorothiazide | Watch for dehydration, nocturia (night falls) |
| Alpha-blockers | Significant orthostatic hypotension | Tamsulosin, Doxazosin, Terazosin | First-dose effect; caution in older adults |
| Hypoglycemics (esp. insulin, sulfonylureas) | Hypoglycemia → dizziness, syncope | Insulin, Glipizide, Glyburide | Prefer agents with lower hypoglycemia risk |
| Antiepileptics | Sedation, ataxia, dizziness | Gabapentin, Pregabalin, Phenytoin | Dose-related effects; renal dosing is important |
The Case Study illustrates why a fall that did not result in a serious injury should not be dismissed. A single fall may identify a patient with unrecognized gait impairment, medication burden, environmental hazards, or early functional decline. The appropriate response is not reassurance alone, but rather an in-depth assessment of modifiable risk factors and the selection of targeted interventions.2,6,7
Community-Dwelling Versus Care-Facility Populations
Risk profiles differ by setting. Community-dwelling older adults are the population targeted by the USPSTF recommendations, and much of the strongest evidence on assessing and addressing fall risk comes from this setting.2,18 Care-facility populations typically have higher dependency, greater cognitive impairment, higher medication burden, and different staffing and supervision environments.14,19,20 Evidence from one setting should not be assumed to transfer automatically to the other.2,19
Case Study Example A 74-year-old woman reports two near-falls when rising from bed. Her medications include a nightly benzodiazepine for insomnia, an opioid for knee osteoarthritis, a selective serotonin reuptake inhibitor, and two antihypertensives. She also wears multifocal lenses and uses a cane inconsistently. What review and home safety questions can be asked of the patient? |
This case illustrates the accumulation of risk factors. The most useful next step is not to isolate a single cause prematurely, but to perform an in-depth assessment that includes medication review, orthostatic evaluation, gait and balance assessment, and questions about home safety.5,7,9
Screening and Assessment in Clinical Practice
Effective fall prevention begins with systematic screening and targeted risk assessment to identify older adults at increased risk of falls. Multiple organizations provide evidence-based guidance to support clinical decision-making, including the AGS, World Falls Guidelines (WFG), USPSTF, and the Centers for Disease Control and Prevention (CDC).2,7,21,22
The AGS, WFG, and the CDC recommend that all adults older than 65 years be screened annually for a history of falls or balance impairment.7,21,22 These include a history of one or more falls in the prior year, as well as evidence of physical or cognitive frailty.7,21,22 This approach supports routine screening rather than waiting for a major injury. The USPSTF recommends screening for community-dwelling adults aged 65 years or older who are at increased risk for falls and have a history of falls or mobility, gait, or balance impairment.1,2
While these guidelines vary in scope and emphasis, they consistently support a stepwise approach that includes initial screening, identification of key risk factors, and, when indicated, a more comprehensive multifactorial assessment to guide individualized prevention strategies.
STEADI and STEADI-Rx
The CDC developed the STEADI (Stopping Elderly Accidents, Deaths, and Injuries) initiative as a practical framework to support fall prevention in clinical settings. A core component of this approach is the STEADI Three Key Screening Questions, which provide a rapid method for identifying older adults at increased risk for falls. The Three Key Screening Questions are as follows:22,23
Have you fallen in the past year?
Are you worried about falling?
Do you feel unsteady when standing or walking?
If a patient answers yes to any one of these questions, an assessment of the patient’s modifiable risk factors and fall history is recommended.24 Thereafter, interventions to reduce the risk of falls are discussed and implemented as appropriate.24
Useful Resources Centers for Disease Control and Prevention. Pocket Guide: Preventing Falls in Older Patients. CDC. 201924 https://www.cdc.gov/steadi/media/pdfs/steadi-pocketguide-508.pdf National Council on Aging: Falls Prevention Resource Center National Council on Aging: State Falls Prevention Coalitions https://www.ncoa.org/page/falls-prevention/ |
To further support interprofessional care, STEADI-Rx was developed as an extension of the CDC STEADI initiative, specifically for pharmacists. STEADI-Rx provides guidance on screening patients in the pharmacy setting, conducting medication reviews to identify fall-risk–increasing drugs, and implementing interventions in collaboration with other members of the healthcare team.25
The AGS 2025 Guidelines
The AGS released updated fall prevention guidance in 2025, incorporating emerging evidence and insights from prior recommendations, including the 2022 WFG.4 These updates also reflect real-world implementation considerations, including feedback from primary care clinicians.4
The updated AGS approach retains the STEADI Three Key Screening Questions (STEADI-3) as the initial step in fall risk identification. However, it emphasizes a more streamlined and flexible workflow, recommending that the additional “Stay Independent” screening questions be used selectively, primarily in patients who screen positive on the initial questions.4
Importantly, the AGS highlights that screening and assessment should not delay intervention. When fall risk is readily apparent, such as in patients with clear gait instability or recurrent falls, clinicians may proceed directly to targeted interventions (e.g., referral to physical therapy) without requiring a more extensive assessment process.4
This pragmatic approach aims to improve clinical efficiency while maintaining patient-centered, individualized care. The current AGS guidelines are outlined in Table 3.
Table 3
AGS Fall Prevention Recommendations4
| Domain | Recommendations |
| Patient and team engagement | Frame fall risk management as a chronic condition using “concern” about falling instead of “fear” Identify patient-specific goals for safe mobility based on what matters most to them Identify available team members and maximize their involvement Tailor the STEADI toolkit for success
|
/// Screening | /// Develop and use pre-visit tools, such as questionnaires and safety checklists, to improve efficiency in fall-risk assessment. Use STEADI-3 (“Three Key Questions”) always and STEADI-12 (“Stay Independent Screener”) for comprehensive assessment when STEADI-3 is positive. |
| Assessment | Assess for orthostatic blood pressure changes if at high risk. Add hearing screening to fall risk assessments. Add cognitive screening to fall risk assessments. Focus medication review on fall risk–increasing drugs (FRIDs) for targeted management. |
| Intervention | Address urinary symptoms by emphasizing nonpharmacologic interventions and promoting environmental modifications for safer nighttime mobility. Ensure older adults get 1000–2000 IU vitamin D3 daily, considering bone health and fall-related injury risk. Recommend appropriate interventions (e.g., cognitive-behavioral therapy, evidence-based fall prevention classes) to address concerns about falling. Develop STEADI resources for additional interprofessional team members to ensure comprehensive fall-risk assessment and intervention across roles and primary care settings. |
Components of Multifactorial Assessment
When a more in-depth assessment is warranted, it should focus on modifiable risk factors. The USPSTF and AGS/British Geriatrics Society (BGS) describe multifactorial assessment as encompassing fall history, gait and balance, vision, postural blood pressure, medications, environment, cognition, and psychological health.2,7 Updated STEADI recommendations also support attention to hearing and bladder health in selected patients.4
A comprehensive fall history is essential for risk stratification and should distinguish between single and recurrent falls, and between injurious and noninjurious events. Key elements include the circumstances of the fall (location and activity), presence of prodromal symptoms such as dizziness or presyncope, footwear at the time of the fall, use of assistive devices, exposure to alcohol or sedating medications, and the patient’s ability to rise independently after the fall.4,7
Medication review is a critical component of assessment and should reflect actual medication use rather than prescribed regimens alone.6,26 This includes evaluation of as-needed (PRN) hypnotics, duplicate sedative therapies, over-the-counter sleep aids, and the timing of antihypertensive administration, all of which may contribute to fall risk.6,26,27
Assessment of gait, balance, and mobility is central to fall risk evaluation. Commonly used tools include the Timed Up and Go (TUG) test, which the American Geriatrics Society continues to support, rather than replacing it with gait speed alone.1,8 Additional components of a comprehensive assessment include measurement of postural blood pressure, evaluation of orthostatic symptoms, vision assessment, and examination of the feet and footwear. Environmental factors should also be assessed, as these domains often reveal directly modifiable contributors to fall risk.7,11,12
Linking Fall Risk Assessment to Targeted Interventions
Effective fall prevention requires aligning identified deficits with targeted interventions. Exercise-based interventions are most appropriate for patients with impairments in balance, gait, strength, or overall functional mobility.2,12 Medication review is indicated when fall-risk–increasing drugs are present, including CNS-active polypharmacy, sedative duplication, or potential overtreatment of blood pressure.6,9,14
Environmental modification should be prioritized when the patient’s history or home safety evaluation reveals hazards such as poor lighting, unsafe bathroom access, difficulty with transfers, or improper use of assistive devices.12 Vision assessment and referral are warranted when visual impairment, including cataracts, reduced visual acuity, or uncorrected refractive errors, contributes to fall risk.7,10
Consistent with guidance from the UPSSTF and the CDC STEADI initiative, interventions should be selective and individualized, rather than applied as a uniform package to all at-risk older adults.2,4
This positive screen should not be dismissed because the patient denies a completed fall. Instead, it should trigger a more comprehensive assessment focused on gait and balance, medication exposure, bathroom urgency, nighttime environmental hazards, and a possible referral to an exercise-based intervention.4,7
Interventions
Interventions to reduce the risk of falls focus on modifiable risk factors. Physical health and strength can be improved through exercise; vision and foot care can be improved; high-risk drugs can be deprescribed during medication reviews; and home modifications can be made to eliminate trip hazards.
Interventions differ between the AGS and the USPSTF.2,7 Recommended interventions target modifiable contributors and may include exercise programs, environmental modifications, medication review, management of visual impairment, treatment of orthostatic hypotension, and optimization of mobility and assistive device use.7,12 The AGS emphasizes a multifactorial, individualized, and patient-centered approach, in which interventions are selected based on identified deficits in domains such as gait, balance, strength, and medication use.8 In contrast, the USPSTF takes a more nuanced position on multifactorial interventions based on the evidence. The USPSTF finds that multifactorial interventions provide only a small net benefit, so they should be individualized rather than routinely applied.2 Instead, the USPSTF emphasizes and recommends structured exercise for adults 65 and older at increased risk of falling.2 The following sections discuss various interventions that may reduce the risk of falls in older adults.
Home Safety and Environmental Modification
Interventions may include addressing urinary symptoms and promoting environmental modifications for safer nighttime mobility.5 Environmental modifications could include securing the flooring or loose carpeting, installing handrails, or otherwise making the environment safe for passage.5
A 2023 Cochrane review of environmental interventions found that home safety assessment and modification programs, particularly when conducted by an occupational therapist, reduce falls in higher-risk community-dwelling populations.12 Guideline sources also emphasize footwear and foot problems as modifiable contributors.7 In practice, risk often reflects the interaction of clutter, poor lighting, unsafe bathroom routes, ill-fitted assistive devices, multifocal lenses, and sedating medications rather than a single defect.7,12
Exercise
In 2018, the USPSTF studied the impact exercise can have on fall rates among community-dwelling older adults.2 The USPSTF reviewed balance and functional training, as well as strength, resistance, flexibility, and endurance training. The various types of exercise consisted of two to three sessions per week for about 12 months.1,2 The review analyzed 62 randomized clinical trials involving 35,058 participants to arrive at this recommendation.1 The USPSTF found that exercise was an effective intervention for reducing falls in community-dwelling adults aged 65 years or older who were at increased risk for falls.1 Based on these findings, the USPSTF recommended exercise to prevent falls in this population, assigning a B recommendation.1 The USPSTF renewed this recommendation in 2024.2 This recommendation is consistent with the 2019 Cochrane review, which found a 23% reduction in fall rates and a reduction in the number of people experiencing one or more falls across exercise interventions overall.1
The effectiveness of exercise-based fall prevention is influenced by adherence, frequency, volume, and duration of the program.28 In order to benefit meaningfully, patients must faithfully attend the program during its weekly scheduled times and for the long-term.18,28 Most studies on exercise as an intervention are for 24 or more weeks.18 This supports the view that exercise interventions should be at least 25 weeks in duration to be effective.29 Long-term exercise programs (≥1-year duration) have also been studied.30 In a review of 40 long-term programs, the authors found that they were associated with a reduction in falls, injurious falls, and probably fractures in older adults, including people with cardiometabolic and neurological diseases.30
Balance and functional exercise routines seem to be the most effective, followed by balance and functional exercises plus resistance exercises, and then Tai Chi.18,31 Tai Chi may also provide more than physical benefits.31 There are cognitive and social components that contribute to its efficacy in enhancing balance and preventing falls in older adults.31 Tai Chi may be preferred by selected patients looking for more than physical improvement.18,31
Effective exercise interventions can be delivered in individual, group, home-based, and professionally supervised formats.1,2 The 2019 Cochrane review reported larger effects when interventions were delivered by a health professional.18 Clinicians should therefore choose a program that the patient can realistically perform, whether that means home-based work for transportation-limited patients or structured supervised therapy for those needing progression and feedback.4,18
Case Study Example A 76-year-old man with two falls in the past year asks whether starting Tai Chi online is enough. What nonpharmacologic recommendations can be provided to the patient? |
The evidence supports Tai Chi as a reasonable exercise option, but stronger, more consistent effects have been reported for balance and functional exercises, as well as for multiple-component programs that also include strength training. If his screening shows gait instability or lower-extremity weakness, referral to a structured, progressive balance-plus-strength program may be preferable to tai chi alone.18,31
Medication Review and Deprescribing
Medication review is one of the most effective fall-prevention interventions because it is often modifiable.19,20 A 2026 systematic review and meta-analysis found that deprescribing in adults aged 65 years and older was feasible and may reduce adverse events that may lead to falls.9 The 2024 USPSTF and AGS/BGS guidelines list drugs that should or may be reviewed and deprescribed.7
Identifying Potentially Inappropriate Medications
Managing drug treatment in older people is complex, often due to patient multimorbidity.32 There is no “one-size-fits-all” solution; that is, a comprehensive evaluation of the patient’s health is essential for optimal medication management.32
Tools are available to guide healthcare teams in developing a patient’s drug regimen to optimize health outcomes. The AGS Beers Criteria (2023) remain a practical tool across ambulatory, acute, and institutional settings, excluding hospice and end-of-life care.15 They flag several fall-relevant classes and strongly recommend avoiding concurrent use of three or more CNS-active medications because of increased risk of falls and fractures.15 The STOPP/START version 3 provides complementary criteria.17 The STOPP criteria attempt to identify medications that could be harmful or produce adverse effects in older adults, and that may be deprescribed or avoided.32 The START criteria, on the other hand, highlight medications that are essential for treating or managing an older patient’s mental or physical health conditions.32
The AGS and STOPP/START tools identify several medication classes relevant to falls, including benzodiazepines, nonbenzodiazepine benzodiazepine receptor agonist hypnotics, tricyclic antidepressants, antipsychotics, opioids, and concurrent CNS-active polypharmacy.15,17
Clinical Pearl While the AGS and STOPP/START criteria provide a structured approach to identifying harmful versus essential medications, they should be viewed as initial screening tools.32 These tools do not replace clinical judgment since the primary care physician has the final decision on medication changes.6,20,32 |
High-risk Medication Classes
Benzodiazepines and Z-drugs remain among the most consistently implicated classes in fall risk.15,16 A 2025 cross-sectional fall cohort identified sedative-hypnotic exposure in 15.5% of older adults presenting with falls and found higher fracture rates among users.16 Clinically, these drugs should trigger review for indication, duration, duplicate sedative exposure, and taper feasibility.15-17
Opioids, anticholinergic medications, antidepressants, antipsychotics, and concurrent CNS-active combinations also contribute through sedation, impaired attention, dizziness, orthostasis, or cumulative CNS burden.13-15 For pharmacists, an anticholinergic-focused review is useful not because anticholinergic exposure is the only risk, but because it frequently coexists with hypnotics, opioids, and antidepressants in the same patient.13,15 In care facilities, the prevalence of concurrent use of three or more CNS-active medications illustrates how quickly fall risk can accumulate with polydrug prescribing compared to single-drug regimens.14
Antihypertensives should not be treated as uniformly inappropriate, but they deserve careful review when low blood pressure, frailty, dizziness, orthostatic symptoms, or recurrent falls suggest overtreatment.9,11
Pharmacist-Led and Team-Based Medication Review
A 2025 systematic review of pharmacist-led interventions for polypharmacy management in older adults found that pharmacist involvement, especially with validated tools such as STOPP/START, reduced potentially inappropriate prescribing and could reduce fall-risk medication use; the strongest outcomes were seen with physician-pharmacist collaboration.6
Deprescribing and Follow-up Considerations
Deprescribing should be deliberate, collaborative, and monitored. The evidence on residential aged care indicates that involving the usual prescriber in implementation is a distinguishing feature of successful interventions.20 That principle translates well to ambulatory care: a consultant pharmacist’s recommendation is more likely to change outcomes when the primary prescriber agrees with the rationale and follow-up plan.6.20
Follow-up should match the class being reduced. For sedative-hypnotics, clinicians should monitor for withdrawal symptoms, rebound insomnia, anxiety, and substitution with other sedating agents.20,26 For opioids, pain control and function should be reassessed, with attention to whether nonpharmacologic or safer pharmacologic alternatives are being used.26 For antihypertensives, clinicians should monitor blood pressure, orthostatic symptoms, dizziness, and recurrence of hypertension-related concerns after dose reduction or discontinuation.9
The goal is not indiscriminate medication reduction. Rather, it is to identify medications whose current harms outweigh their current benefits in the context of the patient’s fall history, symptoms, function, and care setting.9,15,16 For many older adults, the highest-yield action is not a wholesale regimen overhaul but rather the removal of a nightly sedative, the reduction of CNS-active polypharmacy, or the adjustment of an antihypertensive regimen that contributes to orthostasis.6,20,21 Medication classes and deprescribing considerations relevant to falls are covered in Table 4 below.
Table 4
Medication Classes and Deprescribing Considerations
| Medication domain | Why it matters for fall risk | Practical review questions |
|---|---|---|
Benzodiazepines/ Z-drugs | Flagged in Beers and STOPP/START; associated with sedation and fall risk15,16 | Is there an active indication? Is use chronic? Can tapering or safer alternatives be discussed?15,26 |
| Opioids | CNS effects and combination risk with other sedatives15,13 | Is pain benefit still meaningful? Are nonopioid or nonpharmacologic options feasible?26 |
| Anticholinergic/ psychoactive burden | Contributes to confusion, sedation, visual effects, and cumulative CNS risk15,13 | What is the total CNS-active/anticholinergic load? Are duplicate or lower-value drugs present?15,14 |
| Concurrent ≥3 CNS-active drugs | Strongly discouraged in Beers because of falls/fractures15; prevalent in nursing homes14 | Can one or more agents be deprescribed, dose-reduced, or replaced?15,6 |
| Antihypertensives in frailty/orthostasis | Deprescribing may reduce adverse events, including orthostatic hypotension, in selected patients9 | Are low BP, dizziness, orthostasis, or recurrent falls suggesting overtreatment?9,11 |
Case Study Example An 82-year-old woman is seen after an emergency department visit for a fall. A physician-pharmacist medication review identifies nightly lorazepam, a PRN Z-drug, chronic opioid therapy, and three antihypertensives despite low clinic blood pressures and lightheadedness on standing. What medication reassessment should occur? |
This is a high-yield deprescribing case. The regimen contains several fall-risk-increasing drugs, CNS-active polypharmacy, and a plausible orthostatic contributor. A structured plan should prioritize sedative reduction, review of opioid necessity, and reassessment of antihypertensive intensity with monitoring after changes.6,9,15,21
Vitamin D
The AGS also recommends that older adults get 1000–2000 IU of vitamin D3 daily to support bone health and reduce the risk of fall-related injuries.4 This recommendation differs from the USPSTF’s guidelines. The USPSTF removed vitamin D from the main scope of fall-prevention recommendations in 2013.1,2 This was reaffirmed in 2018 and further expanded in December 2024 when the USPSTF withdrew its recommendation for vitamin D supplements for all community-dwelling adults.2
Vitamin D remains the most controversial domain. One 2024 network meta-analysis reported that vitamin D at 800 to 1000 IU/day was associated with a lower risk of falls in some subgroups, particularly with daily dosing and in populations with deficiency.22 By contrast, a 2023 meta-analysis of 17 randomized controlled trials found no statistically significant reduction in risk of at least one fall or recurrent falls with vitamin D supplementation alone in unselected older adults.23 The USPSTF response was not to endorse routine supplementation for fall prevention, but to step away from a direct fall-prevention recommendation while the vitamin D evidence is considered separately.2
Vision Assessment and Correction
Vision impairment is a recognized contributor to falls.2,7 In a prospective cohort study of 329 older adults awaiting bilateral cataract surgery, first-eye surgery was associated with a 33% reduction in incident falls.10 This supports ophthalmologic assessment and correction when visual impairment is clinically relevant, but broader claims about all vision interventions would overstate the available evidence.10
Orthostatic Hypotension
Orthostatic symptoms often indicate a directly modifiable contributor. First-line strategies include hydration, head-of-bed elevation, compression garments, physical counter-pressure maneuvers, graduated exercise, and comprehensive medication review to identify causative agents.7,11 A 2025 review emphasized medication review and first-line nonpharmacologic measures, including hydration, compression garments, head-of-bed elevation, physical counter-pressure maneuvers, and graduated exercise.11
Assistive Devices and Mobility Supports
Assistive devices can reduce fall risk when appropriately selected, fitted, and used, but misuse can itself contribute to falls. Assessment should ask whether the device is correctly fitted, whether the patient has been trained to use it, whether it is used consistently at times when falls occur, and whether it creates hazards during transfers or toileting.12,7 More device-specific comparative evidence was limited in the supplied source set, so stronger claims about the superiority of one device type over another would require additional research.
Table 5
Targeted Non-exercise Interventions After Fall-Risk Assessment
| Risk domain | What to assess | Potential intervention direction |
|---|---|---|
| Home hazards | Lighting, clutter, bathroom route, stairs, rugs, transfers12,7 | Home safety assessment and modification, especially for high-risk patients, should include an occupational therapist12 |
| Vision | Cataract history, low visual acuity, refractive problems10,7 | Vision review and referral when impairment is clinically relevant10,7 |
| Orthostatic symptoms | Dizziness on standing, postural triggers, contributing medications11,7 | Hydration, compression, physical counter-pressure maneuvers, head-of-bed elevation, medication review11 |
| Assistive device use | Fit, training, consistency of use, transfer safety12,7 | Device reassessment, training, environmental adaptation7 |
Education and Behavioral Interventions
Cognitive-behavioral therapy or evidence-based fall-prevention classes may be useful for addressing concerns about falling. The AGS recommends their use in appropriate cases.4
Community-Dwelling Older Adults Versus Care Facilities
Community-dwelling older adults
The USPSTF recommendations are specifically directed at community-dwelling adults aged 65 years or older who are at increased risk for falls.2 In this setting, the strongest evidence domains are exercise, individualized multifactorial interventions with small net benefit, and selected home-safety interventions for higher-risk patients.2,18,12 Community practice also places greater emphasis on screening tools, such as STEADI, outpatient physical therapy referral, medication reconciliation across prescribers, and adherence to home-based recommendations.4,6
Care Facilities
The needs of care-facility populations differ significantly. A large nursing home study also documented a high prevalence of CNS-active polypharmacy.14 These residents often have higher dependency, more cognitive impairment, all of which may increase the risk for falls.19,14 A 2025 Cochrane review on care facilities found that exercise, medication review targeting fall-risk medications, multidisciplinary team-based approaches, environmental modifications, hip protectors for fracture prevention, and vitamin D supplementation in residents with deficiency were effective interventions for reducing falls.19 A regular analysis of polypharmacy showed that a tool-based, team-involved medication review was effective for deprescribing.20 This can be done effectively in a nursing home setting because of the professional staff.19,14 As such, these findings should not be applied automatically to community-dwelling older adults but should be considered on a case-by-case basis.19
Case Study Example
Compare two patients: a 70-year-old woman living independently who falls while turning quickly outside, and an 88-year-old long-term care resident with dementia, recurrent transfer-related falls, and multiple CNS-active medications.
How do these cases differ? Both have fall risk, but the intervention context is different. The first case aligns more closely with the USPSTF community-dwelling framework, emphasizing exercise and selective multifactorial care. The second requires care-facility evidence, repeated team review, and more structured implementation within the residential environment.2,19,20
Interprofessional Collaboration
Interprofessional collaboration improves fall prevention by aligning diverse expertise to identify and address multiple risk factors. This results in more comprehensive, individualized care. When nurses, physicians, physical therapists, occupational therapists, and pharmacists communicate and coordinate assessments, interventions, and follow-up, gaps in care are reduced, resulting in lower fall rates and related harms.
The AGS recommends that STEADI resources be made available for interprofessional team members to ensure comprehensive fall-risk assessment and intervention across roles and primary care settings.4 Fall prevention works best when physicians and pharmacists operate in coordination rather than in parallel. The updated STEADI recommendations emphasize engaging available interdisciplinary team members and redesigning workflow to fit limited primary care time.4 This matters because fall-risk reduction usually requires multiple changes over time rather than a single intervention.4,6
Physicians diagnose contributing conditions, determine whether a more comprehensive workup is needed, order targeted evaluations, and select or authorize interventions such as physical therapy or ophthalmology referrals, orthostatic evaluation, and medication changes.2,7 They also individualize whether multifactorial intervention is warranted, consistent with USPSTF guidance.2
Pharmacists identify fall-risk-increasing drugs, conduct medication reconciliation, quantify CNS-active polypharmacy, recommend deprescribing or safer alternatives, and reinforce adherence and monitoring plans after medication changes.6,21 The available evidence suggests these interventions are strongest when they use validated tools and are integrated with physician decision-making rather than functioning as isolated recommendations.6,20
The USPSTF and STEADI materials describe multifactorial interventions that may involve physical or occupational therapists, exercise instructors, dietitians, and other clinicians.2,4 In care facilities, nursing professionals and other staff often conduct assessments or reinforce intervention plans.19,20 Occupational therapy is particularly relevant when home safety assessment and modification are needed.12 Vision care referral is indicated when cataracts or other clinically important visual impairment are present.7,10
Patient care begins with routine annual screening or opportunistic screening after a fall-related encounter.4,7 Patients screening positive can then be sorted broadly into those who clearly need exercise or physical therapy referral, those whose medication regimen is a major contributor and need physician-pharmacist review, and those whose history points toward environmental, visual, or orthostatic contributors requiring targeted evaluation.5,6,12 Documentation should capture fall history, modifiable contributors, medication changes or recommendations, referrals, and planned follow-up because benefits depend on implementation.4,20,21
Summary
Falls in older adults remain common, clinically consequential, and multifactorial. Community-dwelling adults aged 65 years and older continue to experience high rates of falls, fall-related injuries, emergency care use, hospitalization, and death, with the greatest burden seen in the oldest age groups.
Across USPSTF updates, the most stable conclusion has been that exercise offers the clearest benefit for community-dwelling older adults at increased risk for falls. Multifactorial interventions still have a role, but the 2024 recommendation sharpened the message that they should be individualized rather than uniformly offered. Vitamin D changed differently: it was removed from the main scope of recommendations rather than converted into a broadly positive falls-prevention recommendation.
In practice, the highest-yield approach is a targeted plan built from screening and assessment findings. Exercise, medication review and deprescribing, environmental modification, management of orthostatic contributors, and selected vision-related interventions address different risk domains. Physicians and pharmacists are well-positioned to lead this work together by identifying risks, revising prescribing practices, coordinating referrals, and ensuring follow-through across settings.
References
Guirguis-Blake JM, Michael YL, Perdue LA, Coppola EL, Beil TL. Interventions to Prevent Falls in Older Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2018;319(16):1705-1716. doi:10.1001/jama.2017.21962
Nicholson W.K., Silverstein M., Wong J.B., Barry M.J., Chelmow D., Coker T.R., et al. Preventive Services Task Force U.S. Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2024;332:51–57. doi: 10.1001/jama.2024.8481
Moreland B, Kakara R, Henry A. Trends in Nonfatal Falls and Fall-Related Injuries Among Adults Aged ≥65 Years - United States, 2012-2018. MMWR Morb Mortal Wkly Rep. 2020;69(27):875-881. Published 2020 Jul 10. doi:10.15585/mmwr.mm6927a5
Johnson TM, Vincenzo JL, De Lima B, et al. Updating STEADI for Primary Care: Recommendations From the American Geriatrics Society Workgroup. J Am Geriatr Soc. 2025 Jan 29;73(7):2019–2028. doi: 10.1111/jgs.19378
Parab KV, Arora A, Kang J, Mahajan HP. Exploring Indoor Home Environment Factors Influencing Fear of Falling: A Systematic Review. J Appl Gerontol. 2025;44(5):702-714. doi:10.1177/07334648241286332
McGrory F, Elnaem MH. Pharmacist-Led Interventions for Polypharmacy Management in Older Adults: A Systematic Review of Strategies and Outcomes. Pharmacy (Basel). 2025;13(4). doi:10.5750/ejpch.v4i1.1056
Moncada LV. Management of falls in older persons: a prescription for prevention (summary of AGS/BGS 2011 guideline). Am Fam Physician. 2011;84(11):1267-76.
Eckstrom E, Vincenzo JL, Casey CM, et al. American Geriatrics Society response to the World Falls Guidelines. J Am Geriatr Soc. 2024;72(6):1669-1686. doi:10.1093/ptj/pzab236
Floriani C, Minchio G, Schulthess-Lisibach AE, et al. Deprescribing antihypertensive medications in older people: a systematic review and a meta-analysis. BMC Geriatr. 2026;26(1):222. doi:10.1007/s40266-022-00957-8
Palagyi A, Morlet N, McCluskey P, et al. Visual and refractive associations with falls after first-eye cataract surgery. J Cataract Refract Surg. 2017;43(10):1313-1321. doi:10.1016/j.jcrs.2017.07.029
Owen CM, Frith J. Strategies for Non-Pharmacological Management of Orthostatic Hypotension in Older People: Bridging Pathophysiology and Practice. Br J Hosp Med. 2025;86(12):1-17. doi:10.12968/hmed.2024.0956
Clemson L, Stark S, Pighills AC, et al. Environmental interventions for preventing falls in older people living in the community (Cochrane Review). Cochrane Database Syst Rev. 2023;3(3):CD013258. doi:10.1002/14651858.CD013258
Haddad YK, Luo F, Karani MV, et al. Psychoactive medication use among older community-dwelling Americans. J Am Pharm Assoc. 2019;59(5):686-690. doi:10.1002/14651858.CD007146.pub3
Jung H, Liu SH, Hume AL, et al. The Prevalence of Central Nervous System-Active Polypharmacy in US Nursing Homes. J Am Med Dir Assoc. 2026;27(6):106178. doi:10.1016/j.jamda.2023.09.009
By the 2023 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372
Imani MH, Imani AH, Saem A, et al. Sedative-hypnotic drug use and risk of falls and fractures in elderly patients: a cross-sectional study. BMC Geriatr. 2025;25(1):954. doi:10.1001/jamanetworkopen.2024.59883
O'Mahony D, Cherubini A, Guiteras AR, et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med. 2023;14(4):625-632. doi:10.1186/s13063-020-4139-0
Sherrington C, Fairhall NJ, Wallbank GK, et al. Exercise for preventing falls in older people living in the community (Cochrane Review). Cochrane Database Syst Rev. 2019;1(1):CD012424. doi:10.1002/14651858.CD012424
Dyer SM, Kwok WS, Suen J, et al. Interventions for preventing falls in older people in care facilities (Cochrane Review). Cochrane Database Syst Rev. 2025;8(8):CD016064. doi:10.1136/bmj.g1687
Suen J, Narayan S, Seppala LJ, et al. Features of successful medication review and deprescribing interventions for fall prevention in residential aged care facilities. Age Ageing. 2025;54(8). doi:10.1093/ageing/afaf230
Montero-Odasso M, van der Velde N, Martin FC, et al. World guidelines for falls prevention and management for older adults: a global initiative. Age Ageing. 2022;51(9):afac205. doi:10.1093/ageing/afac205
Centers for Disease Control and Prevention. STEADI - Older Adult Fall Prevention. About STEADI. August 4, 2025. Accessed April 28, 2026. https://www.cdc.gov/steadi/about/index.html
Kannoth S, Mielenz TJ, Eby DW, et al. Adapted Stopping Elderly Accidents, Deaths, and Injuries Questions for Falls Risk Screening: Predictive Ability in Older Drivers. Am J Prev Med. 2021;61(1):105-114. doi:10.1016/j.amepre.2021.02.013
Centers for Disease Control and Prevention. Pocket Guide: Preventing Falls in Older Patients. CDC. 2019. Accessed May 8, 2026. https://www.cdc.gov/steadi/media/pdfs/steadi-pocketguide-508.pdf
Centers for Disease Control and Prevention. STEADI-Older Adult Fall Prevention. Pharmacy Care (STEADI-Rx). CDC. August 4, 2025. Accessed May 8, 2026. https://www.cdc.gov/steadi/hcp/clinical-resources/pharmacy-care.html
Selman K, Roberts E, Niznik J, et al. Initiative to deprescribe high-risk drugs for older adults presenting to the emergency department after falls. J Am Geriatr Soc. 2024;72 Suppl 3:S60-S67. doi:10.1111/jgs.18947
Albert SM, Roth T, Toscani M, Vitiello MV, Zee P. Sleep Health and Appropriate Use of OTC Sleep Aids in Older Adults-Recommendations of a Gerontological Society of America Workgroup. Gerontologist. 2017;57(2):163-170. doi:10.1093/geront/gnv139
van Gameren M, Voorn PB, Bossen D, et al. The effectiveness of a nation-wide implemented fall prevention intervention in the Netherlands in reducing falls and fall-related injuries. BMC Geriatr. 2026;26(1):227. doi:10.1503/cmaj.131330
Ishigaki EY, Ramos LG, Carvalho ES, Lunardi AC. Effectiveness of muscle strengthening and description of protocols for preventing falls in the elderly: a systematic review. Braz J Phys Ther. 2014;18(2):111-118. doi:10.1590/s1413-35552012005000148
de Souto Barreto P, Rolland Y, Vellas B, Maltais M. Association of Long-term Exercise Training With Risk of Falls, Fractures, Hospitalizations, and Mortality in Older Adults: A Systematic Review and Meta-analysis. JAMA Intern Med. 2019;179(3):394-405. doi:10.1001/jamainternmed.2018.5406
Dong R, Hamzah MSGB, Awang MMB, et al. Effects of Tai Chi on balance and fall prevention in healthy older adults: a randomized controlled meta-analysis. Front Public Health. 2025;13:1638006. doi:10.3390/sports5030052
Lunghi C, Domenicali M, Vertullo S, et al. Adopting STOPP/START Criteria Version 3 in Clinical Practice: A Q&A Guide for Healthcare Professionals. Drug Saf. 2024;47(11):1061-1074. doi:10.1007/s40264-024-01453-1
DISCLAIMER
The information provided in this course is general in nature, and it is designed solely to provide participants with continuing education credit(s). This course and materials are not meant to substitute for the independent, professional judgment of any participant regarding that participant’s professional practice, including but not limited to patient assessment, diagnosis, treatment, and/or health management. Medical and pharmacy practices, rules, and laws vary from state to state, and this course does not cover the laws of each state; therefore, participants must consult the laws of their state as they relate to their professional practice.
Healthcare professionals must consult their employer, healthcare facility, hospital, or other organization for guidelines, protocols, and procedures to follow. The information provided in this course does not replace those guidelines, protocols, and procedures, but is for academic purposes only, and this course’s limited purpose is for the completion of continuing education credits.
Participants are advised and acknowledge that information related to medications, their administration, dosing, contraindications, adverse reactions, interactions, warnings, precautions, or accepted uses is constantly changing. Any person taking this course understands that such a person must make an independent review of medication information before any patient assessment, diagnosis, treatment and/or health management. Any discussion of off-label use of any medication, device, or procedure is informational only, and such uses are not endorsed hereby.
Nothing contained in this course represents the opinions, views, judgments, or conclusions of RxCe.com LLC. RxCe.com LLC is not liable or responsible to any person for any inaccuracy, error, or omission with respect to this course or course material.
© RxCe.com LLC 2026: All rights reserved. No reproduction of all or part of any content herein is allowed without the prior, written permission of RxCe.com LLC.
RxCe.com
© RxCe.com LLC 2025: All rights reserved.