CTF Summary Table: Preventing injuries in the elderly

Canadian Task Force on Preventive Health Care

Summary Table of Recommendations

Please note: In 2003, the CTF updated its Grades of Recommendations to include an "I Recommendation" for situations where insufficient evidence exists to allow a recommendation to be made. (Formerly, these situations were captured under a "C Recommendation".) This change is not retroactive, and all "C Recommendations" made prior to 2003 have not been reevaluated in light of the new "I" recommendation grade. For a discussion of these recommendation grades, please link to the 2003 article in the Canadian Medical Association Journal here.

Prevention of Household and Recreational Injuries in the Elderly

Prepared by R. Wayne Elford, MD, CCFP, FCFP, Professor and Director of Research and Faculty Development, Department of Family Medicine, University of Calgary, Alberta

These recommendations were finalized by the Task Force in June 1993

MANEUVER EFFECTIVENESS LEVEL OF EVIDENCE <REF> RECOMMENDATION

Perform multidisciplinary post-fall assessment on elderly patients. Significant reduction in subsequent falls/injuries in the elderly, if assessment done after first fall Randomized controlled trial <6,18> (I) Good evidence to refer to multidisciplinary post-fall assessment team (where service is available). (A)

Monitor elderly patients for medical impairment (balance, medication, gait abnormalities). Association between falls in elderly and medical impairment. Expert opinion <19> (III) Insufficient evidence to include or exclude. (C)

Use safety aids in hazardous areas such as stairs, bathtubs

a) Legislation Decrease rate of injury with modification of stairs. Cohort analytic study <17> (II-2) Fair evidence to implement. (B)

b) Individual Counselling Little information about ability of physician to influence use of safety devices. Expert opinion <20> (III) Insufficient evidence to include or exclude. (C)

Use non-flammable fabrics and self extinguishing cigarettes

a) Public Health Education Association between burns and scalds in the elderly and smoking or cooking practices. Expert opinion <20> (III) Insufficient evidence to implement. (C)

b) Individual Counselling Little information about ability of physician to influence behaviour. Expert opinion <14> (III) Insufficient evidence to include or exclude. (C)

Link to Full Text of this review

Link to Structured Abstract of this review

Link to Selected References list of this review

Link to 1994 chapter: Prevention of Household and Recreational Injuries in Children (<15 years of age)

Link to 1994 chapter: Prevention of Household and Recreational Injuries in Adults

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MANEUVER	EFFECTIVENESS	LEVEL OF EVIDENCE <REF>	RECOMMENDATION
Perform multidisciplinary post-fall assessment on elderly patients.	Significant reduction in subsequent falls/injuries in the elderly, if assessment done after first fall	Randomized controlled trial <6,18> (I)	Good evidence to refer to multidisciplinary post-fall assessment team (where service is available). (A)
Monitor elderly patients for medical impairment (balance, medication, gait abnormalities).	Association between falls in elderly and medical impairment.	Expert opinion <19> (III)	Insufficient evidence to include or exclude. (C)
Use safety aids in hazardous areas such as stairs, bathtubs
a) Legislation	Decrease rate of injury with modification of stairs.	Cohort analytic study <17> (II-2)	Fair evidence to implement. (B)
b) Individual Counselling	Little information about ability of physician to influence use of safety devices.	Expert opinion <20> (III)	Insufficient evidence to include or exclude. (C)
Use non-flammable fabrics and self extinguishing cigarettes
a) Public Health Education	Association between burns and scalds in the elderly and smoking or cooking practices.	Expert opinion <20> (III)	Insufficient evidence to implement. (C)
b) Individual Counselling	Little information about ability of physician to influence behaviour.	Expert opinion <14> (III)	Insufficient evidence to include or exclude. (C)