⚠ Evidence warning: Clinical trials or other evidence do not support the claims that correcting low vitamin D reduces falls and improves muscle function, that A Matter of Balance reduces falls, and that stacking fall-prevention steps compounds the benefit or cuts fall risk by a third to a half. This page keeps it as a report of what people, websites or other media say.

Fracture Prevention and Fall Risk

Fracture Prevention and Fall Risk — scientific infographic poster
🦴 Interactive Visualization Bone Remodeling & Calcium Balance Watch osteoclasts tunnel and osteoblasts rebuild — then drop vitamin D and see parathyroid hormone (PTH) quietly strip calcium out of your skeleton. Launch →

Table of Contents

  1. Why Falls, Not Bone Density, Break Hips
  2. The Numbers Behind Falls in Older Adults
  3. Intrinsic Risk Factors — What Is Happening Inside You
  4. Extrinsic Risk Factors — Your Environment
  5. The STEADI Screening Framework
  6. Timed Up & Go, 30-Second Chair Stand, and Other Bedside Tests
  7. The Medication Review Nobody Does
  8. Vitamin D for Fall Reduction — What the Evidence Actually Says
  9. Tai Chi, Otago, and A Matter of Balance
  10. Home Modifications That Actually Work
  11. Hip Protectors — The Unloved Intervention
  12. The Post-Fracture Care Gap and Fracture Liaison Services
  13. Putting It Together: A Personal Fall-Prevention Plan
  14. Key Research Papers
  15. Connections
  16. Featured Videos

Why Falls, Not Bone Density, Break Hips

Here is the uncomfortable truth that most osteoporosis conversations skip: bones do not break on their own. In the overwhelming majority of hip, wrist, and pelvic fractures, something tipped the person over first. That is why a 70-year-old with osteopenia who never falls rarely fractures, while a 70-year-old with the same T-score who falls twice a year ends up in the operating room.

Treating osteoporosis is not just about bisphosphonates and calcium. It is about making sure the floor never meets your hip at 4 mph. The bone-density work protects you if you fall. The fall-prevention work keeps you from falling in the first place. Both matter, and almost every serious fracture-prevention program does both simultaneously.

This page is the fall-prevention half of that equation. It is written for people who already know they have low bone density, for caregivers worried about an aging parent, and for anyone who has noticed a subtle loss of balance and wants to act before the first fracture — not after.

The Numbers Behind Falls in Older Adults

The main figures on falls and hip fractures:

These are not numbers to panic over — they are numbers to plan around. Every item in the rest of this page chips away at them. A good fall-prevention program, consistently followed, typically reduces fall rates by 20–40%. Stacking several interventions is often said to compound the reduction; the reviews of combined programs quoted under the plan below report smaller effects.

Intrinsic Risk Factors — What Is Happening Inside You

Intrinsic factors are the ones that travel with you. They are why the same icy sidewalk does not fracture every pedestrian.

Age and Sarcopenia

After age 50, the average adult loses about 1–2% of muscle mass and up to 3% of muscle strength per year. By 80, many people have lost 30–40% of the leg strength they had at 30. Weak quadriceps and hip abductors mean that when your center of mass drifts, you cannot catch it. Sarcopenia is the single most modifiable intrinsic risk factor — see the exercise article.

Balance and Proprioception

Balance is not a single skill. It depends on three inputs: the inner ear (vestibular), vision, and joint-position sense (proprioception). Any one can degrade with age; when two fail at once — cataracts plus peripheral neuropathy, for example — falls become nearly inevitable without training.

Vision

Poor vision roughly doubles fall risk. Uncorrected refractive error, cataracts, macular degeneration, and glaucoma all contribute. Bifocals and progressive lenses are a specific hazard on stairs because the near-reading segment blurs the step edge. Single-distance glasses for walking outdoors meaningfully reduces outdoor fall rates.

Orthostatic Hypotension

Roughly one in five older adults drops 20+ mmHg of systolic blood pressure on standing. The resulting lightheadedness — especially the first steps out of bed or after a meal — is a classic cause of unexplained falls. A home check for it: lying flat for five minutes, recording blood pressure (BP), standing, and recording again at one and three minutes. A drop of 20 systolic or 10 diastolic is diagnostic.

Peripheral Neuropathy

Diabetic, chemotherapy-induced, alcoholic, or idiopathic neuropathy blunts the feedback from feet to brain. You literally cannot feel the floor. Patients often describe it as "walking on pillows." Neuropathy triples the risk of recurrent falls.

Cognitive Impairment

Mild cognitive impairment and dementia raise fall risk through several mechanisms: slower reaction time, impaired dual-tasking (walking while talking), poor judgment about hazards, and reduced ability to remember safety strategies. Patients with Alzheimer's disease fall at roughly twice the rate of cognitively intact peers.

Fear of Falling

After one fall, many older adults develop a conditioned fear that paradoxically increases risk: they stiffen, take shorter steps, avoid activity, lose more strength, and fall again. The syndrome has a name — post-fall anxiety — and it is specifically addressed by programs like A Matter of Balance (below).

Extrinsic Risk Factors — Your Environment

Most falls among older adults happen at home, on flat ground, in familiar rooms, during routine activities. The environment is rarely exotic. The usual culprits:

The STEADI Screening Framework

The U.S. Centers for Disease Control and Prevention's STEADI initiative — Stopping Elderly Accidents, Deaths, and Injuries — is a practical toolkit built for primary-care use with every patient 65+. It takes about 10 minutes and consists of three steps:

1. Screen. Three yes/no questions:

  1. Have you fallen in the past year?
  2. Do you feel unsteady when standing or walking?
  3. Do you worry about falling?

A "yes" to any one triggers the next step. Alternatively, the 12-item Stay Independent questionnaire gives a numeric fall-risk score.

2. Assess. The clinician performs a structured evaluation: gait and balance testing (below), orthostatic vitals, medication review, visual acuity check, foot exam, and a cognitive screen (Mini-Cog or similar).

3. Intervene. Targeted actions based on what was found: physical therapy referral, medication deprescribing, home safety evaluation by occupational therapy, vitamin D check, cataract referral, and so on.

A patient can name it at a visit, in words such as: "I am worried about falls. Can we do a STEADI assessment at my next visit?" The materials — patient brochures, provider checklists, pocket cards — are all free at the U.S. Centers for Disease Control and Prevention (CDC) website.

Two newer statements cover the same ground. The 2024 U.S. Preventive Services Task Force statement concludes that exercise gives a moderate net benefit for people 65 or older at increased risk of falling, and that multifactorial programs (a plan tailored after a personal risk assessment) give a small one. In the review behind it, exercise lowered falls (incidence rate ratio 0.85) and injurious falls (incidence rate ratio 0.84). The 2022 World Guidelines for falls prevention recommend opportunistic case finding of fall risk in community-dwelling older adults (looking for it at ordinary visits), with a comprehensive multifactorial risk assessment offered to those at high risk.

Timed Up & Go, 30-Second Chair Stand, and Other Bedside Tests

You do not need a laboratory to measure fall risk. Two three-minute tests capture most of it. Both can be done at home with a stopwatch and a sturdy armchair.

Timed Up & Go (TUG)

Sit in a standard chair. On "go," stand up, walk 10 feet (3 meters) at a normal pace, turn around, walk back, and sit down. Time the whole maneuver.

30-Second Chair Stand

Sit in a standard chair with arms folded across your chest. On "go," stand fully upright and sit back down as many times as possible in 30 seconds. Count completed stands. Age- and sex-stratified thresholds — below the cutoff indicates elevated fall risk:

4-Stage Balance Test

Four progressively harder stances, each held for 10 seconds: feet side-by-side, one foot half in front of the other (semi-tandem), feet in a full tandem line, then single-leg stance. Inability to hold full tandem for 10 seconds predicts a fourfold rise in injurious falls.

Repeating these tests every six to twelve months after age 65 shows the trend over time and can catch decline early, when it is still reversible with exercise.

The Medication Review Nobody Does

Medications are one of the most under-addressed fall-risk factors. Every additional drug on your list raises risk a little; several classes raise it a lot. This list is what a prescriber’s review goes through. Reference frameworks: the Beers Criteria (American Geriatrics Society) and STOPP/START criteria (European).

Highest-Risk Classes

Proton Pump Inhibitors — The Quiet Contributor

Long-term proton pump inhibitor (PPI) use (omeprazole, pantoprazole, esomeprazole, and relatives) has been associated with a 10–30% increased risk of hip fracture in observational studies. The proposed mechanism is reduced calcium absorption and accelerated bone turnover. Proton pump inhibitors (PPIs) do not cause falls directly, but they reduce the bone's tolerance for the ones that do happen. A 2019 meta-analysis of 24 observational studies gives a hip fracture risk ratio of 1.20 (95% confidence interval 1.14–1.28), and 1.24 for long-term use; observational data of this kind cannot show cause. More than a year of use without a clear ongoing indication (Barrett's esophagus, erosive esophagitis, nonsteroidal anti-inflammatory drug (NSAID) gastroprotection) is the situation in which a trial off is usually raised.

How Deprescribing Works

A deprescribing visit works from the full medication list, including over-the-counter sleep aids, allergy pills, and supplements, and from two questions: "Which of these raises my fall risk? Which can we taper or stop?" Most high-risk drugs require a gradual taper; abrupt discontinuation of benzodiazepines, opioids, or selective serotonin reuptake inhibitors can be dangerous in its own right. A pharmacist-led medication review (covered by Medicare's annual wellness visit) is one of the highest-yield hours an older adult can spend.

Vitamin D for Fall Reduction — What the Evidence Actually Says

The vitamin D fall-prevention story has gone in a circle. Early trials in the 2000s suggested that 800 international units (IU) daily reduced falls by roughly 20%. This led to broad recommendations to supplement every older adult. More recent, larger trials — including the VITAL substudy and the 2018 U.S. Preventive Services Task Force (USPSTF) evidence review — show that in community-dwelling older adults who are not vitamin D deficient, supplementation does not meaningfully reduce falls or fractures. The VITAL falls report (25,871 adults, 2000 international units daily, median 5.3 years) found no difference in 2 or more falls (odds ratio 0.97). The Task Force issued a newer falls statement in 2024 (see STEADI). Very high monthly doses have actually increased falls: in a 2016 trial of 200 people aged 70 or older with a prior fall, 66.9% fell on 60,000 international units monthly and 66.1% on 24,000 international units plus calcifediol, against 47.9% on 24,000 international units monthly. The same concern is voiced about 50,000 international units monthly, a dose that trial did not test.

What survives the scrutiny:

Tai Chi, Otago, and A Matter of Balance

Exercise is the single most evidence-backed fall-prevention intervention. The effect sizes are among the largest in geriatrics: well-designed programs cut fall rates by 20–30% and injurious falls by more. A 2019 Cochrane review (108 trials, 23,407 people living in the community) found that exercise reduces the rate of falls by 23% and the number of people falling by 15%, both high-certainty results. In a 2019 trial among people aged 70 or older who had already fallen, a home-based strength and balance program lowered further falls compared with usual care (incidence rate ratio 0.64).

Tai Chi

A 2017 meta-analysis of 18 trials with over 3,800 participants (Huang et al.) found a lower chance of falling at least once with tai chi, about 20% (risk ratio 0.80), and a lower rate of falls (incidence rate ratio 0.69), and noted that the results might be influenced by publication bias. The Tai Ji Quan: Moving for Better Balance program, a simplified eight-form version developed at the Oregon Research Institute, has been adopted by the U.S. Centers for Disease Control and Prevention and community fitness organizations nationwide. Typical dose: 60 minutes, twice weekly, for 24 weeks. Effect builds slowly; meaningful balance gains usually appear around week 12.

A head-to-head trial compared that program with other exercise among 670 adults aged 70 or older at high risk of falling, over 24 weeks. Tai ji quan lowered falls compared with stretching (incidence rate ratio 0.42), and by 31% compared with a mixed exercise program (incidence rate ratio 0.69).

Otago Exercise Program

Developed in New Zealand, Otago is a set of 17 progressive strength and balance exercises performed at home, three times weekly for 30 minutes, plus a short walk twice weekly. A physical therapist visits to teach and progress the program. In the original trials and multiple replications, Otago reduced falls by roughly 35% in higher-risk older adults (age 80+ or with a history of falling). A 2010 meta-analysis of seven trials (1,503 people, mean age 81.6) gives a fall rate ratio of 0.68 and a risk ratio for death over 12 months of 0.45, with no significant difference in serious or moderate fall injury (risk ratio 1.05). Of the 747 people still in the studies at 12 months, 36.7% were still exercising three or more times a week. It is Medicare-covered when prescribed by a physician through home health or outpatient PT.

A Matter of Balance

An eight-session group program designed specifically for people with fear of falling — the post-fall anxiety that keeps people indoors and accelerates deconditioning. Combines cognitive-behavioral techniques, gentle exercise, and problem-solving. Delivered free or low-cost through many Area Agencies on Aging. The program is described as reducing falls and restoring willingness to go outside. A 1998 Boston trial (434 people aged 60 or older with fear of falling) reports more intended activity and greater mobility control right after the program, and better social function and mobility range at 12 months; its abstract gives no fall reduction, and calls the effects "immediate but modest", fading over time with no booster sessions.

General Dose Guidance

Across programs, three common threads predict success: a genuine balance challenge (standing on one leg, narrow stances, dual tasks), strength work targets legs and hips, and total dose exceeds 50 hours over at least 12 weeks. Less than that rarely moves the needle.

Home Modifications That Actually Work

An occupational-therapy home assessment, performed once in your own rooms, is worth more than any generic checklist. Where that is not available, this list covers the same ground. Nearly all of it costs under $500 total and takes a weekend.

Lighting

Bathrooms

Floors

Stairs

Bedroom and Kitchen

Footwear

Indoor: closed-heel shoes or slippers with rubber soles. Outdoor: low heels, broad base, good tread, and ideally ties or Velcro rather than slip-ons. In winter, ice cleats that strap over regular shoes (traction devices) dramatically reduce outdoor falls.

Hip Protectors — The Unloved Intervention

Hip protectors are padded undergarments with foam or hard-shell pads positioned over the greater trochanter of each hip. A hard-shell protector redirects the force of a sideways fall away from the femoral neck.

The Cochrane systematic review of hip protectors (Santesso 2014) concluded that in the specific setting of institutional care (nursing homes, assisted living), hip protectors produce a small reduction in hip fractures — about 11 fewer people per 1000 having a hip fracture (risk ratio 0.82, 95% confidence interval 0.67–1.00). In community-dwelling older adults, the same review found little or no effect (risk ratio 1.15, 95% confidence interval 0.84–1.58; two more people per 1000 having a hip fracture). It found probably little to no effect on falls, a possible slight rise in the small risk of pelvic fractures, and poor adherence, particularly in the long term: people find them bulky, hot, and uncomfortable in pajamas.

The use case usually described: a high-risk older adult living in assisted living, recently hospitalized for a fall, or with a history of one hip fracture on the other side. Hip protector underwear is sold direct-to-consumer for roughly $70–$100 per pair. Three pairs allow daily rotation through the laundry. Wearing them during waking hours is the minimum usually described; many falls in frail older adults happen in the evening or overnight bathroom trip.

The Post-Fracture Care Gap and Fracture Liaison Services

Here is the most-broken part of the system, and the easiest to fix if you are the patient or family member advocating for care: most patients in the United States who break a hip do not go on to use osteoporosis medication. In insurance claims for 96,887 people aged 50 or older hospitalized for a hip fracture from 2002 to 2011, the estimated share using it within 12 months was 28.5% overall, falling from 40.2% in 2002 to 20.5% in 2011. Those figures cover hip fractures only. The orthopedic surgeon fixes the bone; the hospitalist manages the acute stay; the primary care doctor inherits the patient; and somewhere in the handoffs, nobody writes the prescription. In a 2007 trial of yearly intravenous zoledronic acid started within 90 days of hip fracture repair, any new clinical fracture occurred in 8.6% vs 13.9% on placebo (a 35% risk reduction), and deaths from any cause were 9.6% vs 13.3% (a 28% reduction).

A prior fragility fracture roughly doubles the risk of a future fracture. A hip fracture on one side raises the risk of a hip fracture on the other side by a factor of 2 to 5. This is the population with the most to gain from bisphosphonates, denosumab, or anabolic agents, and simultaneously the population least likely to receive them. The 2022 Clinician’s Guide states that any new fracture in an adult aged 50 or older signals imminent elevated risk of further fractures, particularly in the following year.

The Fracture Liaison Service (FLS) Model

A Fracture Liaison Service is a nurse-coordinator-driven program embedded in a hospital or orthopedics practice. The FLS nurse systematically identifies every patient admitted with a fragility fracture, orders appropriate workup (DEXA, calcium, 25-OH-D, parathyroid hormone, sometimes celiac serology or protein electrophoresis), starts therapy or schedules it within 8 weeks of discharge, and hands off to primary care with a written plan.

Where FLS programs exist, secondary fracture rates drop 30–40%. A 2018 meta-analysis gives unweighted average re-fracture rates of 13.4% in control groups and 6.4% with the service. A 2024 meta-analysis gives a risk ratio of 0.68 at 2 or more years (moderate certainty). They are standard of care in Australia, the UK, and much of Europe; in the U.S. they are spreading but still spotty. The American Society for Bone and Mineral Research and the National Bone Health Alliance maintain a directory of certified FLS sites.

What Can Be Raised Where a Hospital Has No FLS

After any fragility fracture — hip, vertebra, wrist, pelvis, humerus — in anyone 50 or older, three actions are usually raised before leaving the hospital or at the first follow-up:

  1. A DEXA scan within 3 months (if not done recently).
  2. A basic workup for secondary causes — see secondary osteoporosis.
  3. A specific osteoporosis medication prescribed before discharge or at the first outpatient visit. Zoledronic acid (a single annual intravenous (IV) infusion) is particularly suited to the post-fracture setting because adherence with oral bisphosphonates in frail older adults is notoriously poor.

Putting It Together: A Personal Fall-Prevention Plan

One practical sequence, in order:

  1. Self-testing. Stopwatch, armchair, 30-Second Chair Stand, Timed Up & Go, with the numbers written down.
  2. A medication review. Every pill and supplement goes on the table, with specific questions about anticholinergics, sleep aids, proton pump inhibitors, and antihypertensive burden.
  3. A vitamin D level, not a prophylactic megadose. A common practice is to supplement only below 30 ng/mL, targeting 30–50; the 2024 Endocrine Society guideline found no clear evidence for an optimal target and suggests against routine testing in the populations it considered (see vitamin D).
  4. An eye exam. Updated glasses, and for some people separate single-distance pairs for walking and reading.
  5. A walk through the home at dusk with the usual lights. Photographs record the hazards, and the top five are the first fixes.
  6. A structured program. Tai Chi: Moving for Better Balance, Otago, or A Matter of Balance — whichever is available locally, for at least 12 weeks.
  7. For people with osteoporosis, a check on whether drug treatment is in place. See the osteoporosis overview.
  8. After any fall, even one without injury, a visit within a week. Falls cluster, so "I'm fine" can miss the next one.

Done consistently, this combination is said to cut fall risk by roughly a third to a half. Reviews of combined programs report less. In the 2024 Task Force evidence review, multifactorial programs lowered the number of falls (incidence rate ratio 0.84) but not significantly the chance of having one or more falls (risk ratio 0.96) or fall-related fractures (incidence rate ratio 1.01). A 2018 Cochrane review gives a rate ratio for falls of 0.77, on low-quality evidence. In the STRIDE trial of nurse-run fall prevention plans (5,451 people, mean age 80), serious fall injuries were not significantly lower (4.9 vs 5.3 per 100 person-years), though self-reported fall injuries were (hazard ratio 0.90). For a person whose bone density puts them on the edge of a fragility fracture, that is frequently the difference between a long independent life and a year in a rehab facility.

Key Research Papers

Foundational randomized trials, Cochrane reviews, and major guidelines underpinning the fall-prevention, exercise, medication-deprescribing, and post-fracture care information on this page.

  1. Tinetti ME, Baker DI, McAvay G, et al. A Multifactorial Intervention to Reduce the Risk of Falling Among Elderly People Living in the Community. New England Journal of Medicine. 1994;331(13):821–827. — doi:10.1056/NEJM199409293311301
  2. Lamb SE, Jørstad-Stein EC, Hauer K, Becker C; Prevention of Falls Network Europe. Development of a Common Outcome Data Set for Fall Injury Prevention Trials: The ProFaNE Consensus. Journal of the American Geriatrics Society. 2005;53(9):1618–1622. — doi:10.1111/j.1532-5415.2005.53455.x
  3. Liu-Ambrose T, Davis JC, Best JR, et al. Effect of a Home-Based Exercise Program on Subsequent Falls Among Community-Dwelling High-Risk Older Adults After a Fall: A Randomized Clinical Trial. JAMA. 2019;321(21):2092–2100. — doi:10.1001/jama.2019.5795
  4. Sherrington C, Fairhall NJ, Wallbank GK, et al. Exercise for Preventing Falls in Older People Living in the Community. Cochrane Database of Systematic Reviews. 2019;1(1):CD012424. — doi:10.1002/14651858.CD012424.pub2
  5. Gillespie LD, Robertson MC, Gillespie WJ, et al. Interventions for Preventing Falls in Older People Living in the Community. Cochrane Database of Systematic Reviews. 2012;9:CD007146. — doi:10.1002/14651858.CD007146.pub3
  6. Huang ZG, Feng YH, Li YH, Lv CS. Systematic Review and Meta-Analysis: Tai Chi for Preventing Falls in Older Adults. BMJ Open. 2017;7(2):e013661. — doi:10.1136/bmjopen-2016-013661
  7. Thomas S, Mackintosh S, Halbert J. Does the Otago Exercise Programme Reduce Mortality and Falls in Older Adults? A Systematic Review and Meta-Analysis. Age and Ageing. 2010;39(6):681–687. — doi:10.1093/ageing/afq102
  8. LeBoff MS, Chou SH, Ratliff KA, et al. Supplemental Vitamin D and Incident Fractures in Midlife and Older Adults (VITAL). New England Journal of Medicine. 2022;387(4):299–309. — doi:10.1056/NEJMoa2202106
  9. US Preventive Services Task Force; Grossman DC, Curry SJ, et al. Interventions to Prevent Falls in Community-Dwelling Older Adults: USPSTF Recommendation Statement. JAMA. 2018;319(16):1696–1704. — doi:10.1001/jama.2018.3097
  10. Santesso N, Carrasco-Labra A, Brignardello-Petersen R. Hip Protectors for Preventing Hip Fractures in Older People. Cochrane Database of Systematic Reviews. 2014;3:CD001255. — doi:10.1002/14651858.CD001255.pub5
  11. Wu CH, Tu ST, Chang YF, et al. Fracture Liaison Services Improve Outcomes of Patients with Osteoporosis-Related Fractures: A Systematic Literature Review and Meta-Analysis. Bone. 2018;111:92–100. — doi:10.1016/j.bone.2018.03.018
  12. 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. Journal of the American Geriatrics Society. 2023;71(7):2052–2081. — doi:10.1111/jgs.18372
  13. Cosman F, de Beur SJ, LeBoff MS, et al. Clinician's Guide to Prevention and Treatment of Osteoporosis. Osteoporosis International. 2014;25(10):2359–2381. — doi:10.1007/s00198-014-2794-2
  14. Lyles KW, Colón-Emeric CS, Magaziner JS, et al. Zoledronic Acid and Clinical Fractures and Mortality After Hip Fracture. New England Journal of Medicine. 2007;357(18):1799–1809. — doi:10.1056/NEJMoa074941
  15. Bischoff-Ferrari HA, Dawson-Hughes B, Orav EJ, et al. Monthly High-Dose Vitamin D Treatment for the Prevention of Functional Decline: A Randomized Clinical Trial. JAMA Internal Medicine. 2016;176(2):175–183. — doi:10.1001/jamainternmed.2015.7148
  16. LeBoff MS, Murata EM, Cook NR, et al. VITamin D and OmegA-3 TriaL (VITAL): Effects of Vitamin D Supplements on Risk of Falls in the US Population. Journal of Clinical Endocrinology & Metabolism. 2020;105(9):2929–2938. — doi:10.1210/clinem/dgaa311
  17. Demay MB, Pittas AG, Bikle DD, et al. Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology & Metabolism. 2024;109(8):1907–1947. — doi:10.1210/clinem/dgae290
  18. US Preventive Services Task Force; Nicholson WK, Silverstein M, Wong JB, et al. Interventions to Prevent Falls in Community-Dwelling Older Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2024;332(1):51–57. — doi:10.1001/jama.2024.8481
  19. Guirguis-Blake JM, Perdue LA, Coppola EL, Bean SI. Interventions to Prevent Falls in Older Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2024;332(1):58–69. — doi:10.1001/jama.2024.4166
  20. 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 and Ageing. 2022;51(9):afac205. — doi:10.1093/ageing/afac205
  21. Hopewell S, Adedire O, Copsey BJ, et al. Multifactorial and Multiple Component Interventions for Preventing Falls in Older People Living in the Community. Cochrane Database of Systematic Reviews. 2018;7(7):CD012221. — doi:10.1002/14651858.CD012221.pub2
  22. Bhasin S, Gill TM, Reuben DB, et al. A Randomized Trial of a Multifactorial Strategy to Prevent Serious Fall Injuries. New England Journal of Medicine. 2020;383(2):129–140. — doi:10.1056/NEJMoa2002183
  23. Li F, Harmer P, Fitzgerald K, et al. Effectiveness of a Therapeutic Tai Ji Quan Intervention vs a Multimodal Exercise Intervention to Prevent Falls Among Older Adults at High Risk of Falling: A Randomized Clinical Trial. JAMA Internal Medicine. 2018;178(10):1301–1310. — doi:10.1001/jamainternmed.2018.3915
  24. Tennstedt S, Howland J, Lachman M, Peterson E, Kasten L, Jette A. A Randomized, Controlled Trial of a Group Intervention to Reduce Fear of Falling and Associated Activity Restriction in Older Adults. Journals of Gerontology Series B: Psychological Sciences and Social Sciences. 1998;53(6):P384–P392. — PubMed PMID: 9826971
  25. Seppala LJ, Wermelink AMAT, de Vries M, et al. Fall-Risk-Increasing Drugs: A Systematic Review and Meta-Analysis: II. Psychotropics. Journal of the American Medical Directors Association. 2018;19(4):371.e11–371.e17. — doi:10.1016/j.jamda.2017.12.098
  26. Williamson JD, Supiano MA, Applegate WB, et al. Intensive vs Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged ≥75 Years: A Randomized Clinical Trial. JAMA. 2016;315(24):2673–2682. — doi:10.1001/jama.2016.7050
  27. Harbi H, Nesrallah M, Carney G, et al. Safety of Sodium-Glucose Cotransporter 2 Inhibitors in Older Adults With Type 2 Diabetes: A Cohort Study. Diabetes Care. 2026. — doi:10.2337/dc26-1316
  28. Poly TN, Islam MM, Yang HC, et al. Proton Pump Inhibitors and Risk of Hip Fracture: A Meta-Analysis of Observational Studies. Osteoporosis International. 2019;30(1):103–114. — doi:10.1007/s00198-018-4788-y
  29. Solomon DH, Johnston SS, Boytsov NN, et al. Osteoporosis Medication Use After Hip Fracture in U.S. Patients Between 2002 and 2011. Journal of Bone and Mineral Research. 2014;29(9):1929–1937. — doi:10.1002/jbmr.2202
  30. Danazumi MS, Lightbody N, Dermody G. Effectiveness of Fracture Liaison Service in Reducing the Risk of Secondary Fragility Fractures in Adults Aged 50 and Older: A Systematic Review and Meta-Analysis. Osteoporosis International. 2024;35(7):1133–1151. — doi:10.1007/s00198-024-07052-1
  31. LeBoff MS, Greenspan SL, Insogna KL, et al. The Clinician's Guide to Prevention and Treatment of Osteoporosis. Osteoporosis International. 2022;33(10):2049–2102. — doi:10.1007/s00198-021-05900-y

PubMed Topic Searches

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