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- Title
Effect of a multifactorial, interdisciplinary intervention on risk factors for falls and fall rate in frail older people: a randomised controlled trial.
- Authors
Fairhall, Nicola; Sherrington, Catherine; Lord, Stephen R.; Kurrle, Susan E.; Langron, Colleen; Lockwood, Keri; Monaghan, Noeline; Aggar, Christina; Cameron, Ian D.
- Abstract
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 definition.Intervention: multifactorial, interdisciplinary intervention targeting frailty characteristics with an individualised home exercise programme prescribed in 10 home visits from a physiotherapist and interdisciplinary management of medical, psychological and social problems.Measurements: risk factors for falls were measured using the Physiological Profile Assessment (PPA) and mobility measures at 12 months by a blinded assessor. Falls were monitored with calendars.Results: participants had a mean (SD) age of 83.3 (5.9) years, 68% were women and 216 (90%) completed the study. After 12 months the intervention group had significantly better performance than the control group, after controlling for baseline values, in the PPA components of quadriceps strength (between-group difference 1.84 kg, 95% CI 0.17–3.51, P = 0.03) and body sway (−90.63 mm, 95% CI −168.6 to −12.6, P = 0.02), short physical performance battery (1.58, 95% CI 1.02–2.14, P ≤ 0.001) and 4 m walk (0.06 m/s 95% CI 0.01–0.10, P = 0.02) with a trend toward a better total PPA score (−0.40, 95% CI −0.83–0.04, P = 0.07) but no difference in fall rates (incidence rate ratio 1.12, 95% CI 0.78–1.63, P = 0.53).Conclusion: the intervention improved performance on risk factors for falls but did not reduce the rate of falls.Trial registration: ACTRN12608000250336.
- Subjects
AUSTRALIA; ACCIDENTAL fall prevention; RISK factors of falling down; CONFIDENCE intervals; EXERCISE; FRAIL elderly; HEALTH care teams; HEALTH outcome assessment; REGRESSION analysis; RESEARCH funding; RANDOMIZED controlled trials; DATA analysis software; DESCRIPTIVE statistics
- Publication
Age & Ageing, 2014, Vol 43, Issue 5, p616
- ISSN
0002-0729
- Publication type
Article
- DOI
10.1093/ageing/aft204