Fall Prevention Support Protocol

Geriatric/MusculoskeletalStrong Evidence
5
supplements
2
Primary
3
Supporting
2
Grade A
64
Studies

Primary Stack

Core supplements with strongest evidence
800-2000 IU daily (higher if deficient)

Improves muscle strength and reduces fall risk in deficient individuals

Fall RiskFunctionality in Elderly or Injured
25 studies5,000 participants
1000-1200mg daily (food + supplements)

Supports bone health; combined with vitamin D reduces fracture risk

15 studies3,000 participants

Supporting Stack

Additional supplements for enhanced results
1.0-1.2g/kg/day total protein

Supports muscle mass maintenance; sarcopenia increases fall risk

10 studies800 participants
2-3g EPA+DHA daily

May support muscle health and reduce inflammation

6 studies300 participants
3-5g daily

May support muscle strength in combination with resistance training

8 studies400 participants

How This Protocol Works

Simple Explanation

Falls are a major cause of injury, disability, and death in older adults. Prevention involves addressing multiple risk factors.

FALL RISK FACTORS:

Muscle weakness
Balance problems
Vision impairment
Medications (sedatives, blood pressure meds)
Home hazards
Foot problems
Chronic conditions
Vitamin D deficiency
Cognitive impairment

KEY PREVENTION STRATEGIES:

Exercise: Balance training, strength training, tai chi
Medication review: Reduce sedatives, adjust blood pressure meds
Vision: Regular eye exams, update glasses
Home safety: Remove hazards, improve lighting, grab bars
Footwear: Proper fitting shoes
Vitamin D: Correct deficiency

EXERCISE IS MOST IMPORTANT:

Strength training builds muscle
Balance training prevents falls
Tai chi proven effective
Should be ongoing, not one-time

MEDICATIONS TO REVIEW:

Sedatives/sleep aids
Antidepressants
Blood pressure medications
Pain medications
Antihistamines

* Vitamin D is proven to reduce falls.

* Exercise is the most effective intervention.

* Multifactorial approach works best.

Expected timeline: Vitamin D effects seen over 2-3 months. Strength gains from exercise take 8-12 weeks. Fall reduction seen with consistent intervention.

Clinical Perspective

Fall Prevention: Multifactorial approach most effective. USPSTF: exercise interventions recommended for community-dwelling adults ≥65. Vitamin D supplementation for those with deficiency or at risk.

Key interventions: Exercise (balance, strength, tai chi) has strongest evidence. Vitamin D (800 IU minimum) reduces falls in deficient individuals - evidence mixed for vitamin D replete. Medication review (especially psychotropics, antihypertensives). Home safety assessment. Vision correction. Multifactorial assessment for recurrent fallers. Supplements: vitamin D primary; protein and creatine support muscle mass.

* Vitamin D (A-grade): Fall reduction. Meta-analysis: (PMID: 28202713). 800-2000 IU daily.

* Calcium (A-grade): Bone health. Systematic review: (PMID: 27840029). 1000-1200mg daily.

* Protein (B-grade): Muscle mass. Systematic review: (PMID: 28698222). 1.0-1.2g/kg/day.

* Omega-3 (C-grade): Muscle health. Review: (PMID: 27840029). 2-3g EPA+DHA daily.

* Creatine (B-grade): Strength. Meta-analysis: (PMID: 28615996). 3-5g daily.

Protocol notes: Risk assessment: history of falls, gait/balance, medications, vision, cognition, home hazards. Exercise prescription: balance and strength training; tai chi excellent; supervised initially. Vitamin D: test 25(OH)D if risk factors; supplement if <30 ng/mL. Medications: deprescribe where possible; taper psychotropics. Vision: cataract surgery reduces falls. Footwear: avoid high heels, floppy slippers. Hip protectors: consider for high-risk in care facilities. Post-fall: evaluate for injury, cause, and implement prevention.