Nicola Fairhall

• PhD, MHSci, BPhty.
• PostDoc Position at The University of Sydney

Objective: Exercise is beneficial for fall prevention. Targeting interventions to people who fall more may lead to greater population impacts. As trials have used varying methods to assess participant risk level, prospectively-measured control group fall rates may provide a more accurate and poolable way to understand intervention effects in diffe...

Objective To investigate the trial-based cost-effectiveness of the addition of a tailored digitally enabled exercise intervention to usual care shown to be clinically effective in improving mobility in the Activity and MObility UsiNg Technology (AMOUNT) rehabilitation trial compared to usual care alone. Design Economic evaluation alongside a pragm...

This third edition of a trusted resource brings together the latest literature across multiple fields to facilitate the understanding and prevention of falls in older adults. Thoroughly revised by a multidisciplinary team of authors, it features a new three-part structure covering epidemiology and risk factors for falls, strategies for prevention a...

Background : Frailty is associated with a prodromal stage called pre-frailty, a potentially reversible and highly prevalent intermediate state before frailty becomes established. Despite being widely-used in the literature and increasingly in clinical practice, it is poorly understood. Objective : To establish consensus on the construct and approa...

Background Exercise prevents falls in older adults. Regular updates of estimated effects of exercise on falls are warranted given the number of new trials, the increasing number of older people globally and the major consequences of falls and fall-related injuries. Methods This update of a 2019 Cochrane Review was undertaken to inform the World He...

Background Various physical activity interventions for prevention and treatment of osteoporosis have been designed and evaluated, but the effect of such interventions on the prevention of osteoporosis in older people is unclear. The aim of this review was to investigate the association between physical activity and osteoporosis prevention in people...

Background: Frailty and sarcopenia are common age-related conditions associated with adverse outcomes. Physical activity has been identified as a potential preventive strategy for both frailty and sarcopenia. The authors aimed to investigate the association between physical activity and prevention of frailty and sarcopenia in people aged 65 years...

Objective To model the potential financial implications of Australian programs supporting cognitively impaired community‐dwelling older people. Methods Markov cohort models of (a) an observational study of a residential dyadic training program for carers and people with dementia (GTSAH) and (b) a frailty intervention (FIT) in a cognitively impaire...

Background Disability and falls are common following fall-related lower limb and pelvic fractures. Objective To evaluate the impact of an exercise self-management intervention on mobility-related disability and falls after lower limb or pelvic fracture. Design Randomized controlled trial. Participants Three hundred thirty-six community dwellers...

Objectives To assess the effects of exercise interventions for preventing falls in older people living in the community. Selection criteria We included randomised controlled trials evaluating the effects of any form of exercise as a single intervention on falls in people aged 60+years living in the community. Results Exercise reduces the rate of...

Introduction There is strong evidence that exercise prevents falls in community-dwelling older people. This review summarises trial and participant characteristics, intervention contents and study quality of 108 randomised trials evaluating exercise interventions for falls prevention in community-dwelling older adults. Methods MEDLINE, EMBASE, CEN...

Background Frailty is associated with a prodromal stage called pre-frailty, a potentially reversible and highly prevalent condition before frailty becomes established. Despite this, there is no widely accepted definition of pre-frailty to support its early identification and management. This study applied an international consensus approach to defi...

Objective To determine whether multifactorial falls prevention interventions are effective in preventing falls, fall injuries, emergency department (ED) re-presentations and hospital admissions in older adults presenting to the ED with a fall. Design Systematic review and meta-analyses of randomised controlled trials (RCTs). Data sources Four hea...

Background: At least one-third of community-dwelling people over 65 years of age fall each year. Exercises that target balance, gait and muscle strength have been found to prevent falls in these people. An up-to-date synthesis of the evidence is important given the major long-term consequences associated with falls and fall-related injuries OBJECT...

Hip fractures are a common consequence of falls and are associated with a high risk of death and reduced function. This review aims to quantify the impact of hip fracture on older people’s abilities and quality of life (QOL) over the medium to long term. Cohort studies of hip fracture patients reporting outcomes three months post-fracture or longer...

The study aim was to determine whether an intervention could reduce pre frailty and improve mobility disability. We conducted a single centre, randomised, controlled trial among older people who were pre frail in Sydney, Australia. One group received an intervention targeting the identified characteristics of frailty, while the comparison group rec...

Previous meta-analyses have found exercise as a single intervention prevents falls in older people. This updated systematic review with random effects meta-analysis and meta-regression aimed to test whether this effect is still present when new trials are added and explore trial characteristics associated with greater fall prevention effects. One h...

Question: What is the effect of a multifactorial intervention on frailty and mobility in frail older people who comply with their allocated treatment? Design: Secondary analysis of a randomised, controlled trial to derive an estimate of complier average causal effect (CACE) of treatment. Participants: A total of 241 frail community-dwelling pe...

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects (benefits and harms) of exercise interventions for preventing falls in older people living in the community.

Objective Previous meta-analyses have found that exercise prevents falls in older people. This study aimed to test whether this effect is still present when new trials are added, and it explores whether characteristics of the trial design, sample or intervention are associated with greater fall prevention effects. Design Update of a systematic rev...

Background: Hip fractures are an increasingly common consequence of falls in older people that are associated with a high risk of death and reduced function. This review aims to quantify the impact of hip fracture on older people's abilities and quality of life over the long term. Methods: Studies were identified through PubMed and Scopus search...

Lasting disability and further falls are common and costly problems in older people following fall-related lower limb and pelvic fractures. Exercise interventions can improve mobility after fracture and reduce falls in older people, however the optimal approach to rehabilitation after fall-related lower limb and pelvic fracture is unclear. This ran...

Physical inactivity and falls in older people are important public health problems. Health conditions that could be ameliorated with physical activity are particularly common in older people. One in three people aged 65 years and over fall at least once annually, often resulting in significant injuries and ongoing disability. These problems need to...

Introduction Frailty is a major concern due to its costly and widespread consequences, yet evidence of effective interventions to delay or reduce frailty is lacking. Our previous study found that a multifactorial intervention was feasible and effective in reducing frailty in older people who were already frail. Identifying and treating people in th...

Frailty is a well-recognised, complex syndrome, predominantly affecting older people. Currently, there are two main conceptualizations of frailty: the phenotypic and the accumulated deficit models, with the phenotypic model being more widely applied in clinical research. Based on these models, we contend that a number of the phenotypic frailty comp...

Objective: To compare the costs and cost-effectiveness of a multifactorial interdisciplinary intervention versus usual care for older people who are frail. Design: Cost-effectiveness study embedded within a randomized controlled trial. Setting: Community-based intervention in Sydney, Australia. Participants: A total of 241 community-dwelling...

With the increase in chronic disease and the ageing of the population, understanding requisite self-management adherence of people who are frail is important, especially given its association with service outcomes. This study sought to investigate five key client adherence factors reported in the literature, and frailty reduction in a clinical tria...

Background: frail older people have a high risk of falling.Objective: assess the effect of a frailty intervention on risk factors for falls and fall rates in frail older people.Design: randomised controlled trial.Participants: 241 community-dwelling people aged 70+ without severe cognitive impairment who met the Cardiovascular Health Study frailty...

Background: participation restriction, defined as 'problems an individual may experience in involvement in life situations' (e.g. work and leisure), reflects difficulty functioning at a societal level and is a key component of disability. Our objective was to describe changes in participation in older men over a 2-year period and to identify baseli...

This is the protocol for a review and there is no abstract. The objectives are as follows: To summarise the evidence for the benefits and safety of mobility training on overall functioning and mobility in frail older people living in the community.

Frailty is a well known and accepted term to clinicians working with older people. The study aim was to determine whether an intervention could reduce frailty and improve mobility. We conducted a single center, randomized, controlled trial among older people who were frail in Sydney, Australia. One group received an intervention targeting the ident...

Interventions that enhance mobility in frail older people are needed to maintain health and independence, yet definitive evidence of effective interventions is lacking. Our objective was to assess the impact of a multifactorial intervention on mobility-related disability in frail older people. We conducted a randomised, controlled trial with 241 fr...

the World Health Organization describes individuals' functioning at a societal level as 'participation'. Despite being a key component of functioning and an important goal of rehabilitation, participation is not measured consistently in ageing research. The aim was to evaluate the extent to which measurement of participation has been reported in tr...

Frailty assessment form. Single page template to guide assessment of the frail older person.

Additional recommendations for treatment of the frail older person, classified using the ICF framework. Table illustrating an extensive list of problems seen in the frail older person and evidence based intervention to address each of these problems.

Frailty is a common syndrome that is associated with vulnerability to poor health outcomes. Frail older people have increased risk of morbidity, institutionalization and death, resulting in burden to individuals, their families, health care services and society. Assessment and treatment of the frail individual provide many challenges to clinicians...

This systematic review update includes 54 randomised controlled trials and confirms that exercise as a single intervention can prevent falls (pooled rate ratio 0.84, 95% CI 0.77-0.91). Meta-regression revealed programs that included balance training, contained a higher dose of exercise and did not include walking training to have the greatest effec...

To determine the extent of participation restriction in a sample of frail older people, and to identify the domains of participation that are most restricted. A secondary aim was to determine which health and demographic factors were associated with participation restriction. An observational cross-sectional study. Adults recently discharged from a...

Frailty is a term commonly used to describe the condition of an older person who has chronic health problems, has lost functional abilities and is likely to deteriorate further. However, despite its common use, only a small number of studies have attempted to define the syndrome of frailty and measure its prevalence. The criteria Fried and colleagu...