Home Modification Outcomes for Adults Aged 50 Years and Over and Their Relatives: A Scoping Review.

This is a scoping review, so the authors did not check the quality of any of the included studies. A study could be poorly run or at high risk of bias and still count towards the findings. The falls evidence contradicts itself. Fifteen studies reported fewer falls or lower falls risk, but three studies found no reduction, and one randomised trial found no difference between the groups that had modifications and the groups that did not. Nothing in this review lets you say which of those results to trust. Several reported benefits rest on very little. Reduced pain came from three studies, less need for paid care from three, less need for unpaid family care from two, and better property value from two. One included study was a single case report of one person. Almost nothing is known about cost. Only four of the 38 studies reported what the modifications cost, and the reported figures ranged from under $500 to £4878 per home. The review is about adults aged 50 and over, but several studies did not report ages in detail and a few included much younger participants, with one sample spanning ages 24 to 93. Studies that mixed age groups did not report outcomes separately by age, so the review cannot say whether acting earlier makes a difference. No one with lived experience of home modifications, no funder and no home modification provider was consulted about what the findings mean, which the authors note as a gap. Only peer-reviewed, English-language studies published from July 2011 onwards were included, so unpublished work and research in other languages are missing.

The authors declared no conflicts of interest in relation to the research, authorship or publication of the article. The work was funded by an Impact Research Grant for Aging Well 2023 from the Office for Ageing Well, Government of South Australia. The funding body is not reported as having any role in designing the review, analysing the data or writing it up.

Do not read this review as evidence that home modifications prevent falls. Falls were the most studied outcome, but 15 studies reporting fewer falls or lower falls risk sat alongside three that found no reduction at all, and one randomised trial found no significant difference between the group whose homes were modified and the control group. It is also a scoping review: the authors did not appraise the quality of the 38 studies, and several of the positive findings, such as reduced pain or less need for care, rest on two or three small studies each.