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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p></div><div class="bk_msg_box bk_bttm_mrgn clearfix bk_noprnt"><div class="iconblock clearfix"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/nicecg161/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nicecg161-lrg.png" alt="Cover" height="100px" width="80px" /></a><div class="icnblk_cntnt"><ul class="messages"><li class="info icon"><span class="icon"><a href="/books/n/nicecg161/">See 2013 update</a></span></li></ul></div></div></div><div class="messagearea bk_noprnt" style="margin-bottom:1.3846em "><ul class="messages"><li class="warn icon"><span class="icon">This publication is provided for historical reference only and the information may be out of date.</span></li></ul></div><div class="bk_prnt"><p style="color:red;"><strong>This publication is provided for historical reference only and the information may be out of date.</strong></p></div><div class="pagination bk_noprnt"><span class="inactive page_link prev">< Prev</span><a class="active page_link next" href="/books/n/nicecg21/nicecg21.s1/" title="Next page in this title">Next ></a></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/Book"><div class="meta-content fm-sec"><div class="iconblock whole_rhythm clearfix no_top_margin"><a href="http://www.rcn.org.uk/" title="Royal College of Nursing (UK)" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-nicecg21-lrg.png" alt="Cover of Clinical Practice Guideline for the Assessment and Prevention of Falls in Older People" /></a><div class="icnblk_cntnt"><h1 id="_NBK55851_"><span itemprop="name">Clinical Practice Guideline for the Assessment and Prevention of Falls in Older People</span></h1><p><i>NICE Clinical Guidelines, No. 21</i></p><p class="contrib-group"><span itemprop="author">National Collaborating Centre for Nursing and Supportive Care (UK)</span>.</p><div class="half_rhythm">London: <a href="http://www.rcn.org.uk/" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">Royal College of Nursing (UK)</span></a>; <span itemprop="datePublished">2004 Nov</span>.<div class="small">ISBN-10: <span itemprop="isbn">1-904114-17-2</span></div></div><div class="half_rhythm"><ul class="inline_list"><li><span class="label"><a data-jig="ncbidialog" href="#_ncbi_dlg_cpyrght_NBK55851" data-jigconfig="modal:true">Copyright and
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No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic,mechanical, photocopying, recording or otherwise,without prior permission of the Publishers or a licence permitting restricted copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1T 4LP.This publication may not be lent, resold, hired out or otherwise disposed of by ways of trade in any form of binding or cover other than that in which it is published,without the prior consent of the Publishers.</div></div></div></div></div></div></div><div class="body-content whole_rhythm" itemprop="text"><div itemprop="description"><p>The National Institute for Clinical Excellence (<a class="def" href="/books/n/nicecg21/nicecg21.gl1/def-item/nicecg21.gl1-d17/">NICE</a>) commissioned the National Collaborating Centre for Nursing and Supportive Care (<a class="def" href="/books/n/nicecg21/nicecg21.gl1/def-item/nicecg21.gl1-d16/">NCC-NSC</a>) to develop guidelines on the assessment and prevention of falls in older people. This follows referral of the topic by the Department of Health and Welsh Assembly Government. This document describes the methods for developing the guidelines and presents the resulting recommendations. It is the source document for the NICE (abbreviated version for health professionals) and <i>Information for the public</i> (patient) versions of the guidelines that are published by NICE. A multidisciplinary Guideline Development Group produced the guidelines and the development process was undertaken by the NCC-NSC.</p><p>The main areas examined by the guideline were: the evidence for factors that increase the risk of falling; the most effective methods of assessment and identification of older people at risk of falling; the most clinically and cost effective interventions and preventative strategies for the prevention of falls; the <a class="def" href="/books/n/nicecg21/nicecg21.gl2/def-item/nicecg21.gl2-d7/">clinical effectiveness</a> of hip protectors for the prevention of hip fracture; the most clinically and cost effective interventions and rehabilitation programmes for the prevention of further falls; older peoples' views and experiences of falls prevention strategies and programmes.</p></div><div><h2>Contents</h2><div class="bktoc_all_cntnr top align_right" style="display:none"><ul class="inline_list_right"><li><a class="bktoc_all_exp" href="#">Expand All</a></li><li style="margin-left:.8em"><a class="bktoc_all_clps" href="#">Collapse All</a></li></ul></div><ul id="toc_tllNBK55851_nicecg21_s1" class="simple-list toc toc-toggle"><li class="half_rhythm" id="toc_itm_NBK55851_nicecg21_s1"><a href="/books/n/nicecg21/nicecg21.s1/" class="toc-item">Disclaimer</a></li><li class="half_rhythm" id="toc_itm_NBK55851_nicecg21_s2"><a href="/books/n/nicecg21/nicecg21.s2/" class="toc-item">Guideline Development Group membership and acknowledgements</a></li><li class="half_rhythm" id="toc_itm_NBK55851_nicecg21_s5"><a href="/books/n/nicecg21/nicecg21.s5/" class="toc-item">Terminology</a></li><li class="half_rhythm" id="toc_itm_NBK55851_nicecg21_gl1"><a href="/books/n/nicecg21/nicecg21.gl1/" class="toc-item">Abbreviations</a></li><li class="half_rhythm" id="toc_itm_NBK55851_nicecg21_gl2"><a href="/books/n/nicecg21/nicecg21.gl2/" class="toc-item">General glossary</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch1"><a href="/books/n/nicecg21/ch1/" class="toc-item">1. Executive summary</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch2"><a href="/books/n/nicecg21/ch2/" class="toc-item">2. Principles of practice and summary of guideline recommendations</a><ul id="toc_lst_NBK55851_ch2_s1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK55851_ch2_s1"><a href="/books/n/nicecg21/ch2/#ch2.s1" class="toc-item">2.1 Principles of practice</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch2_s5"><a href="/books/n/nicecg21/ch2/#ch2.s5" class="toc-item">2.2 Summary of guideline recommendations</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK55851_ch3"><a href="/books/n/nicecg21/ch3/" class="toc-item">3. Background to the current guideline</a><ul id="toc_lst_NBK55851_ch3_s1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK55851_ch3_s1"><a href="/books/n/nicecg21/ch3/#ch3.s1" class="toc-item">Clinical need</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK55851_ch4"><a href="/books/n/nicecg21/ch4/" class="toc-item">4. Aims of the guideline</a><ul id="toc_lst_NBK55851_ch4_s1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK55851_ch4_s1"><a href="/books/n/nicecg21/ch4/#ch4.s1" class="toc-item">4.1 Who the guideline is for</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch4_s2"><a href="/books/n/nicecg21/ch4/#ch4.s2" class="toc-item">4.2 Groups covered by the guideline</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch4_s3"><a href="/books/n/nicecg21/ch4/#ch4.s3" class="toc-item">4.3 Groups not covered</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch4_s4"><a href="/books/n/nicecg21/ch4/#ch4.s4" class="toc-item">4.4 Health care setting</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch4_s5"><a href="/books/n/nicecg21/ch4/#ch4.s5" class="toc-item">4.5 Interventions covered</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch4_s6"><a href="/books/n/nicecg21/ch4/#ch4.s6" class="toc-item">4.6 Interventions not covered</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch4_s7"><a href="/books/n/nicecg21/ch4/#ch4.s7" class="toc-item">4.7 Audit support within guideline</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch4_s8"><a href="/books/n/nicecg21/ch4/#ch4.s8" class="toc-item">4.8 Guideline Development Group</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK55851_ch5"><a href="/books/n/nicecg21/ch5/" class="toc-item">5. Methods used to develop the guideline</a><ul id="toc_lst_NBK55851_ch5_s1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK55851_ch5_s1"><a href="/books/n/nicecg21/ch5/#ch5.s1" class="toc-item">5.1 Summary of development process</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch5_s2"><a href="/books/n/nicecg21/ch5/#ch5.s2" class="toc-item">5.2 Risk factors for falling: review methods and results</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch5_s35"><a href="/books/n/nicecg21/ch5/#ch5.s35" class="toc-item">5.3 Assessment of those at high risk of falling: review methods and results</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch5_s69"><a href="/books/n/nicecg21/ch5/#ch5.s69" class="toc-item">5.4 Fear of falling as a risk factor and tools to measure fear of falling: methods and results</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch5_s87"><a href="/books/n/nicecg21/ch5/#ch5.s87" class="toc-item">5.5 Interventions for the prevention of falls: review methods and results</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch5_s117"><a href="/books/n/nicecg21/ch5/#ch5.s117" class="toc-item">5.6 Analysis of compliance with interventions for the prevention of falls</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch5_s124"><a href="/books/n/nicecg21/ch5/#ch5.s124" class="toc-item">5.7 Interventions to reduce the psychosocial consequences of falling: review methods and results</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch5_s135"><a href="/books/n/nicecg21/ch5/#ch5.s135" class="toc-item">5.8 Patient views and experiences: review methods and results</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch5_s160"><a href="/books/n/nicecg21/ch5/#ch5.s160" class="toc-item">5.9 Rehabilitation: review methods and results</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch5_s181"><a href="/books/n/nicecg21/ch5/#ch5.s181" class="toc-item">5.10 The effectiveness of hip protectors: review methods and results</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch5_s203"><a href="/books/n/nicecg21/ch5/#ch5.s203" class="toc-item">5.11 Cost effectiveness review and modelling: methods and results</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch5_s219"><a href="/books/n/nicecg21/ch5/#ch5.s219" class="toc-item">5.12 Submission of evidence process</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch5_s220"><a href="/books/n/nicecg21/ch5/#ch5.s220" class="toc-item">5.13 Evidence synthesis and grading</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch5_s221"><a href="/books/n/nicecg21/ch5/#ch5.s221" class="toc-item">5.14 Formulating and grading recommendations</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK55851_ch6"><a href="/books/n/nicecg21/ch6/" class="toc-item">6. Guideline recommendations with supporting evidence reviews</a><ul id="toc_lst_NBK55851_ch6_s1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK55851_ch6_s1"><a href="/books/n/nicecg21/ch6/#ch6.s1" class="toc-item">1.1 Case/risk identification</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch6_s9"><a href="/books/n/nicecg21/ch6/#ch6.s9" class="toc-item">1.2 Multifactorial falls risk assessment</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch6_s27"><a href="/books/n/nicecg21/ch6/#ch6.s27" class="toc-item">1.3 Multifactorial interventions</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch6_s40"><a href="/books/n/nicecg21/ch6/#ch6.s40" class="toc-item">1.4 Strength and balance training</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch6_s46"><a href="/books/n/nicecg21/ch6/#ch6.s46" class="toc-item">1.5 Exercise in extended care settings</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch6_s50"><a href="/books/n/nicecg21/ch6/#ch6.s50" class="toc-item">1.6 Home hazard and safety intervention</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch6_s56"><a href="/books/n/nicecg21/ch6/#ch6.s56" class="toc-item">1.7 Psychotropic medications</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch6_s61"><a href="/books/n/nicecg21/ch6/#ch6.s61" class="toc-item">1.8 Cardiac pacing</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch6_s65"><a href="/books/n/nicecg21/ch6/#ch6.s65" class="toc-item">1.9 Encouraging the participation of older people in falls prevention</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch6_s72"><a href="/books/n/nicecg21/ch6/#ch6.s72" class="toc-item">1.10 Education and information giving</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch6_s76"><a href="/books/n/nicecg21/ch6/#ch6.s76" class="toc-item">1.11 Interventions that cannot be recommended</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch6_s80"><a href="/books/n/nicecg21/ch6/#ch6.s80" class="toc-item">1.12 Interventions that cannot be recommended because of insufficient evidence</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK55851_ch7"><a href="/books/n/nicecg21/ch7/" class="toc-item">7. Recommendations for research</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch8"><a href="/books/n/nicecg21/ch8/" class="toc-item">8. Audit criteria</a><ul id="toc_lst_NBK55851_ch8_s1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK55851_ch8_s1"><a href="/books/n/nicecg21/ch8/#ch8.s1" class="toc-item">Possible objectives for an audit</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch8_s2"><a href="/books/n/nicecg21/ch8/#ch8.s2" class="toc-item">People that could be included in an audit</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch8_s3"><a href="/books/n/nicecg21/ch8/#ch8.s3" class="toc-item">Data sources and documentation of audit</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch8_s4"><a href="/books/n/nicecg21/ch8/#ch8.s4" class="toc-item">Measures that could be used as a basis for an audit</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK55851_ch9"><a href="/books/n/nicecg21/ch9/" class="toc-item">9. Dissemination of guideline</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch10"><a href="/books/n/nicecg21/ch10/" class="toc-item">10. Validation</a></li><li class="half_rhythm" id="toc_itm_NBK55851_ch11"><a href="/books/n/nicecg21/ch11/" class="toc-item">11. Scheduled review of guideline</a></li><li class="half_rhythm" id="toc_itm_NBK55851_references_rl1"><a href="/books/n/nicecg21/references.rl1/" class="toc-item">12. References</a></li><li class="half_rhythm" id="toc_itm_NBK55851_appendixes_app1"><a href="/books/n/nicecg21/appendixes.app1/" class="toc-item">Appendix A Guideline Development Group membership and acknowledgements</a></li><li class="half_rhythm" id="toc_itm_NBK55851_appendixes_app2"><a href="/books/n/nicecg21/appendixes.app2/" class="toc-item">Appendix B Search strategies and databases searched</a></li><li class="half_rhythm" id="toc_itm_NBK55851_appendixes_app3"><a href="/books/n/nicecg21/appendixes.app3/" class="toc-item">Appendix C Quality checklists/data extraction forms</a></li><li class="half_rhythm" id="toc_itm_NBK55851_appendixes_app4"><a href="/books/n/nicecg21/appendixes.app4/" class="toc-item">Appendix D Registered stakeholders</a></li><li class="half_rhythm" id="toc_itm_NBK55851_appendixes_app5"><a href="/books/n/nicecg21/appendixes.app5/" class="toc-item">Appendix E Clinical effectiveness evidence table</a></li><li class="half_rhythm" id="toc_itm_NBK55851_appendixes_app6"><a href="/books/n/nicecg21/appendixes.app6/" class="toc-item">Appendix F Quality assessment of trials</a></li><li class="half_rhythm" id="toc_itm_NBK55851_appendixes_app7"><a href="/books/n/nicecg21/appendixes.app7/" class="toc-item">Appendix G Table of excluded studies</a></li><li class="half_rhythm" id="toc_itm_NBK55851_appendixes_app8"><a href="/books/n/nicecg21/appendixes.app8/" class="toc-item">Appendix H Meta-analysis figures</a></li><li class="half_rhythm" id="toc_itm_NBK55851_appendixes_app9"><a href="/books/n/nicecg21/appendixes.app9/" class="toc-item">Appendix I The scope</a></li></ul><div class="bktoc_all_cntnr align_right" style="display:none"><ul class="inline_list_right"><li><a class="bktoc_all_exp" href="#">Expand All</a></li><li style="margin-left:.8em"><a class="bktoc_all_clps" href="#">Collapse All</a></li></ul></div></div><div><p><b>NICE guideline on the management of osteoporosis – under development</b>: The NCC-NSC is currently developing a guideline for NICE on osteoporosis. It is suggested that when this guideline is published in 2006, it is used in conjunction with these guidelines on falls prevention.</p></div><div><p>This work was undertaken by the National Collaborating Centre for Nursing and Supportive Care (NCC-NSC) and the Guideline Development Group (GDG) formed to develop this guideline. Funding was received from the National Institute for Clinical Excellence (NICE). The NCC-NSC consists of a partnership between: Centre for Evidence-Based Nursing; Centre for Statistics in Medicine; Clinical Effectiveness Forum for Allied Health Professionals, College of Health; Health Care Libraries (University of Oxford); Health Economics Research Centre, Royal College of Nursing and UK Cochrane Centre.</p></div></div></div>
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<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © 2005, Royal College of Nursing.<p class="small">All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic,mechanical, photocopying, recording or otherwise,without prior permission of the Publishers or a licence permitting restricted copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1T 4LP.This publication may not be lent, resold, hired out or otherwise disposed of by ways of trade in any form of binding or cover other than that in which it is published,without the prior consent of the Publishers.</p></div><div class="small"><span class="label">Bookshelf ID: NBK55851</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/21834186" title="PubMed record of this title" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">21834186</a></span></div><div style="margin-top:2em" class="bk_noprnt"><div class="pagination bk_noprnt"><span class="inactive page_link prev">< Prev</span><a class="active page_link next" href="/books/n/nicecg21/nicecg21.s1/" title="Next page in this title">Next ></a></div></div></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK55851/?report=reader">PubReader</a></li><li><a href="/books/NBK55851/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK55851" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK55851" style="display:none" title="Cite this Page"><div class="bk_tt">National Collaborating Centre for Nursing and Supportive Care (UK). Clinical Practice Guideline for the Assessment and Prevention of Falls in Older People. London: Royal College of Nursing (UK); 2004 Nov. (NICE Clinical Guidelines, No. 21.)<span class="bk_cite_avail"></span></div></div></li><li><a href="/books/n/nicecg21/pdf/">PDF version of this title</a> (2.9M)</li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Other titles in this collection</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="source-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/n/nicecollect/">National Institute for Health and Clinical Excellence: Guidance
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