Rationale and Definition of a Living Systematic Review for Cost-effective Falls Prevention Strategies
Living systematic reviews (LSRs) are a systematic review that is continuously updated to incorporate new evidence when available. The benefit of an LSR is that the continuous workflow is intended to ensure consistency of methods, conserve resources and minimize any information loss over time. Further, transparent communication of research questions and methods ensures that access to the intended objectives, approaches, uses and timing of each iteration. The results is that LSRs can help provide a predictable basis of evidence-based information relevant for developing and information health policy and/or clinical guidelines. To date, we have comprehensive sources of effective strategies to prevent falls (link to Cochrane SR), yet from these, we do not yet have a summary source for cost-effective approaches. Thus, we developed a LSR that details cost-effective falls prevention for older adults living in the community, admitted to hospital or residing in an aged-care facility.
Objectives of Our Living Systematic Review
The objectives of our living systematic review are to provide an evidence-based summary detailing the cost-effectiveness of fall prevention interventions for older adults aged 60 years and older in three settings: community-dwelling, aged care facilities, and hospitals (i.e., acute and rehab).
Our Protocol for Living Systematic Review
The protocol for this living systematic review is available and published in BMJ Open.
View our PROSPERO registration
How Living Systematic Reviews work
Living Systematic Review Team Members
Jennifer Davis, Team Lead
Jennifer Davis is an Associate Professor and Canada Research Chair (Tier 2) in the Faculty of Management. Her career goal is to improve the health of Canadians through applied health economic evaluation and outcomes research. Jennifer’s research focuses on conducting economics evaluations alongside randomized controlled trials (i.e., cost-effectiveness and cost-utility analyses) in a variety of clinical settings that include falls, fracture and cognition. A core part of Jennifer’s current research program includes health outcomes research (i.e., exploring the value of patient reported outcome measures) in the fields of healthy aging (i.e., cognition, mobility) and various surgical outcomes. Jennifer also enthusiastically contributes as a co-director of operations of the Falls Prevention Clinic at Vancouver General Hospital. Dr. Davis is working collaboratively on an initiative to apply proven cost-effective and cost-saving secondary falls prevention interventions for high risk older adults across BC. Jennifer has served on the editorial board (since 2008) and as a Deputy Editor (since 2017) for Health Economics Submissions to the British Journal of Sports Medicine (to 2020). Jennifer also serves as an Associate Editor for Scientific Reports.
Teresa Liu-Ambrose, Co-PI
Dr. Liu-Ambrose is a Canada Research Chair (Tier I), Healthy Aging, Director of the Aging, Mobility, and Cognitive Health Laboratory and Co-Director of the Centre for Aging SMART.
Dr. Liu-Ambrose’s research focuses on understanding the role of exercise, and other lifestyle interventions, in promoting cognitive and mobility outcomes in older adults. Her research findings have been implemented into clinical practice, community programs, and international practice guidelines or recommendations to promote healthy aging.
She leads the Canadian Longitudinal Study on Aging (CLSA) Data Collection Site at UBC, the CLSA Neuroimaging Working Group, and the CLSA COVID-19 Brain Health Study. Dr. Liu-Ambrose also co-leads the CLSA Healthy Brains, Healthy Aging initiative.
Dr. Liu-Ambrose’s research laboratory, The Aging, Mobility and Cognitive Health Lab, focuses on defining the role of exercise to promote healthy aging, with a particular focus on cognitive and neural plasticity, as well as mobility. Various method are utilized in the lab, including randomized controlled trials, functional neuroimaging, and actigraphy.
Ian D. Cameron
Ian Cameron is a Consultant Physician in Rehabilitation Medicine and has the Chair in Rehabilitation Medicine, School of Health Sciences, Faculty of Medicine and Health, at the University of Sydney, Australia. He is a clinician researcher. Current research themes are injury, rehabilitation and disability; specifically disability and health in older people, musculoskeletal injury in compensable settings, and catastrophic injury (associated with severe long-term disability). Concurrent with his academic position Ian holds Senior Staff Specialist positions at Hornsby Ku-ring-gai Hospital and Southern NSW Local Health District.
Vrinda Dimri
Vrinda is a first-year PhD student in the Rehabilitation Sciences program under the supervision of Dr. Teresa Liu-Ambrose. She completed her MSc. Research in Psychology from Tilburg University, Netherlands and has a background in clinical and cognitive neuropsychology. Vrinda’s aim is to engage in research that positively shapes the overall wellbeing and functional independence of older adults. Her current work focuses on promoting physical activity behaviours in limited-mobility older adults to improve cognitive health.
Ryan S. Falck
Dr. Ryan Stanley Falck is a Canadian Consortium on Neurodegeneration in Aging (CCNA) postdoctoral fellow at the University of British Columbia working under the supervision of Drs. Teresa Liu-Ambrose and Roger Tam. His research examines how the 24-hour activity cycle (i.e., physical activity, sedentary behaviour, and sleep) impacts cognitive health and risk for dementia. He is also interested in how different lifestyle factors (e.g., exercise training, pet ownership, etc.) can impact physical, mental, and cognitive health. He uses a combination of 1) innovative methodologies for observing physical activity, sedentary behaviour and sleep; 2) state-of-the-art structural and functional neuroimaging analyses for exploring the effects of these behaviours on brain health; and 3) novel analytic approaches (e.g., artificial intelligence and machine learning) for exploring how physical activity, sedentary behaviour, and sleep are related to cognitive health
Kirsten Husdal
Kirsten is a research assistant in the Applied Health Economics Lab at the University of British Columbia Okanagan. She completed her BSc in Behavioural Neuroscience at the University of British Columbia with emphasis cognitive neuropsychology and sensory systems. Her current interests lie in memory disorders and perceptual processing. Outside of her work in research, Kirsten focuses on science communication and knowledge translation
Sohail Loomba
Sohail is a third-year medical student at the Royal College of Surgeons in Ireland, enrolled in the six-year direct-entry medical program. He is involved as a student research at the Aging, Mobility, and Cognitive Health Lab at the University of British Columbia. Sohail is passionate about advancing medical knowledge and plans to pursue residency training in British Columbia, Canada, with a long-term goal of contributing to patient care and healthcare innovation.
Ken Madden
Dr. Ken Madden is a Professor of Medicine and holds the Allan M. McGavin Chair in Geriatric Medicine at the University of British Columbia. He is the Past-President of the Canadian Geriatrics Society and the Editor-in-Chief of the Canadian Geriatrics Journal. He is the director of the Gerontology and Diabetes Research Laboratory and the division head of Geriatric Medicine at the University of British Columbia.
Guilherme Moraes Balbim
Guilherme (Gui) got his PhD in Kinesiology and Nutrition from the University of Illinois at Chicago. Gui is from Brazil, where he received his BS and MSc in Physical Education from the State University of Maringá. During his PhD, his research interests revolved around increasing older Latinos’ physical activity levels with dance interventions and examining its impact on the brain and cognitive health. In Dr. Liu-Ambrose’s lab, in collaboration with the Canadian Space Agency, Gui investigates the efficacy of exercise training in mitigating the effects of experimental bed rest on older adults’ cognitive function and brain health. The research also explores the underlying mechanisms by which both bed rest and exercise training impact cognitive function and its potential moderators. His postdoctoral fellowship is funded by the Canadian Institutes of Health Research (CIHR). In his free time, Gui loves running, cooking, being outdoors, and exploring the city and nature.
Marina B. Pinheiro
Dr. Pinheiro is a Physiotherapist and NHMRC Early Career Fellow at the Institute for Musculoskeletal Health, School of Public Health, University of Sydney. Dr. Pinheiro was awarded her PhD in Health Science in 2017.Marina’s research focuses on investigating the cost-effectiveness of physical activity programs and implementing solutions to improve physical activity promotion by health professionals within routine care. She is the Cost Effectiveness topic leader within the Institute’s Mobility and Falls research theme.
Jordyn Rice
Dr. Jordyn Rice, PT, DPT, PhD is a postdoctoral fellow in the Aging, Mobility, and Cognitive Health Lab at the University of British Columbia. Jordyn completed both her Doctor of Physical Therapy (DPT) and PhD degrees at the University of Miami. As a clinician, she practiced in the acute care and inpatient rehabilitation settings. Her research focuses on understanding the interrelationship between physical and cognitive health in aging adults. Jordyn’s overall career goal is to maximize the health span of older adults using precision exercise interventions targeting physical and cognitive health outcomes.
Catherine Sherrington
Professor Sherrington FAHMS, FACP, PhD, MPH, BAppSc (Physio) is Professor at Sydney School of Public Health, The University of Sydney. Prof Sherrington leads the 28-person Physical Activity, Ageing and Disability Research Stream within the Institute for Musculoskeletal Health (a partnership between the University of Sydney and the Sydney Local Health District) and is Deputy Director of the Institute. Prof Sherrington’s research focuses on the promotion of physical activity and the prevention of falls in older people and people with chronic disabling conditions. Prof Sherrington has authored 280+ refereed journal articles including reports of 47 clinical trials (18 with NHMRC funding) and 26 systematic reviews. The impact of these publications is indicated by publication citation rates (32,7000+ citations), use in at least 127 guidelines from 26 countries (e.g. NICE, WHO) and use by Health Departments (e.g. NSW Ministry of Health inclusion criteria for the Active and Healthy website of physical activity opportunities). Prof Sherrington is ranked # 3 researcher in the world by Scopus (‘independent living/falls’) and Expertscape (‘accidental falls’) and is a Fellow of the Australian Academy of Health and Medical Sciences and Australian College of Physiotherapists.
Research Question
Community-dwelling
Which fall prevention interventions for older adults are cost-effective among individuals who are community-dwelling?
N = 46
Hospital
Which fall prevention interventions for older adults are cost-effective among individuals living in hospital settings?
N = 6
Aged-care
Which fall prevention interventions for older adults are cost-effective among individuals living in aged care facilities?
N = 6
Sponsors
Members of the LSR team are funded by:
Applied Health Economics Research Lab funded by: