168 | Chapter 8 Figure 8.1 Overview of the chain approach for fall prevention in the Netherlands (243). Effective components of fall prevention Falls in older adults is a multifactorial problem, influenced by a variety of factors such as medication review, environmental risk reduction and an exercise-based training program (137, 332). Key elements include the use of evidence-based fall prevention interventions, high-quality design and implementation of the interventions, and effective reach within the target group (41). A multifactorial fall prevention approach preferably involves adaptations to the home and environment as well as addressing medication use, vision impairments, foot problems, and footwear next to an exercise program (41). Additional components, such as dietary interventions, education, psychological support, and medical treatment for cardiovascular and other conditions, can further enhance effectiveness (41). Balance exercises and functional training play a central role in fall prevention programs, with evidence also supporting the inclusion of strength training and Tai Chi to reduce fall risk (137, 179). Effective components of training programmes are challenging balance and strength exercises, and should be performed for at least three hours per week (179). For example, training could be
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