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Three trials tested the effect of additional physiotherapy (supervised exercises) in rehabilitation wards (subacute setting). They may make little or no difference to the risk of falling (RR 0.92, 95% CI 0.81 to 1.05 3153 participants, 9 studies I² = 42% low‐quality evidence). We are uncertain of the effect of multifactorial interventions on the rate of falls (RaR 0.88, 95% CI 0.66 to 1.18 3439 participants, 10 studies I² = 84% very low‐quality evidence). Multifactorial interventions were tested in 13 trials. The population included in these studies had low vitamin D levels. There is moderate‐quality evidence that vitamin D supplementation (4512 participants, 4 studies) probably reduces the rate of falls (RaR 0.72, 95% CI 0.55 to 0.95 I² = 62%), but probably makes little or no difference to the risk of falling (RR 0.92, 95% CI 0.76 to 1.12 I² = 42%). There is low‐quality evidence that general medication review (tested in 12 trials) may make little or no difference to the rate of falls (RaR 0.93, 95% CI 0.64 to 1.35 2409 participants, 6 studies I² = 93%) or the risk of falling (RR 0.93, 95% CI 0.80 to 1.09 5139 participants, 6 studies I² = 48%).

Exercise may make little or no difference to the risk of falling (RR 1.02, 95% CI 0.88 to 1.18 2090 participants, 10 studies I² = 23% low‐quality evidence). We are uncertain of the effect of exercise on rate of falls (RaR 0.93, 95% CI 0.72 to 1.20 2002 participants, 10 studies I² = 76% very low‐quality evidence). Seventeen trials compared exercise with control (typically usual care alone).

Only the falls outcomes for the main comparisons are reported here. Risk of fracture and adverse events were generally poorly reported and, where reported, the evidence was very low‐quality, which means that we are uncertain of the estimates. With few exceptions, the quality of evidence for individual interventions in either setting was generally rated as low or very low. The majority of trials were at high risk of bias in one or more domains, mostly relating to lack of blinding. Overall, we included 95 trials (138,164 participants), 71 (40,374 participants mean age 84 years 75% women) in care facilities and 24 (97,790 participants mean age 78 years 52% women) in hospitals. Thirty‐five new trials (77,869 participants) were included in this update.

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