INTERVENTIONS TO PREVENT FALLS AND FRACTURES IN NURSING HOMES: A SYSTEMIC LITERATURE REVIEW

Abstract

Background. Falls and fall-related fractures are one of the most common and severe problems of older people living in nursing homes. Most of the prevention measures applied in the general community are ineffective due to patients' cognitive dysfunction and a large number of chronic diseases.
The aim of the study was to review the methods of preventing falls and fractures applied in long-term care facilities described in the scientific literature.
Methods. A systematic literature review was conducted. The search for scientific articles was carried out in December 2025 using the MEDLINE. Five randomized controlled trials were selected and included in the final systematic review.
Results. The studies included individuals whose average age ranged from 78 to 86 years. The review covered four areas of different interventions: dietary adjustment, physical exercise, staff training, and floor covering adaptation. Calcium and protein supplementation were found to reduce the risk of both falls and fractures (by 11% and 33%, respectively). Training nursing staff on risk assessment and individualized fall prevention measures had a positive effect of reducing the risk of falls by 43%, which was only observed at beginning of the study. However, this intervention did not influence fracture reduction rates in the early period. Participants in high-intensity functional exercise were 69% less likely to experience moderate and severe (including fractures) falls. Interventions with moderate-intensity exercise and fall-mitigating flooring were not associated with significant effects on falls and fall-related fractures.
Conclusions. Dietary supplementation with calcium and protein, training of nursing staff on risk assessment and application of individual fall prevention measures, and high-intensity functional exercise might be effective measures for the prevention of falls and fall-related injuries.