Multifactorial intervention to reduce falls in older people at high risk of recurrent falls a randomized controlled trial

DE Vries, Oscar J., Peeters, G. M. E. E. (Geeske), Elders, Petra J. M., Muller, Majon, Knol, Dirk L., Danner, Sven A., Bouter, Lex M. and Lips, Paul (2010) Multifactorial intervention to reduce falls in older people at high risk of recurrent falls a randomized controlled trial. JAMA Internal Medicine, 170 13: 1110-1117. doi:10.1001/archinternmed.2010.169

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Author DE Vries, Oscar J.
Peeters, G. M. E. E. (Geeske)
Elders, Petra J. M.
Muller, Majon
Knol, Dirk L.
Danner, Sven A.
Bouter, Lex M.
Lips, Paul
Title Multifactorial intervention to reduce falls in older people at high risk of recurrent falls a randomized controlled trial
Journal name JAMA Internal Medicine   Check publisher's open access policy
ISSN 2168-6106
2168-6114
Publication date 2010-07
Sub-type Article (original research)
DOI 10.1001/archinternmed.2010.169
Open Access Status File (Publisher version)
Volume 170
Issue 13
Start page 1110
End page 1117
Total pages 8
Place of publication Chicago, IL, United States
Publisher American Medical Association
Language eng
Formatted abstract
Background:
Falls occur frequently in older people and strongly affect quality of life. Guidelines recommend multifactorial, targeted fall prevention. We evaluated the effectiveness of a multifactorial intervention in older persons with a high risk of recurrent falls.

Methods:

A randomized controlled trial was conducted from April 3, 2005, to July 21, 2008, at the geriatric outpatient clinic of a university hospital and regional general practices in the Netherlands. Of 2015 persons identified, 217 persons aged 65 years or older were selected to participate. They had a high risk of recurrent falls and no cognitive impairment and had visited the emergency department or their family physician after a fall. The geriatric assessment and intervention were aimed at reduction of fall risk factors. Primary outcome measures were time to first and second falls after randomization. Secondary outcome measures were fractures, activities of daily living, quality of life, and physical performance.

Results:
Within 1 year, 55 (51.9%) of the 106 intervention participants and 62 (55.9%) of the 111 usual care (control) participants fell at least once. No significant treatment effect was demonstrated for the time to first fall (hazard ratio, 0.96; 95% confidence interval, 0.67-1.37) or the time to second fall (1.13; 0.71-1.80). Similar results were obtained for secondary outcome measures and for perprotocol analysis. One intervention participant died vs 7 in the control group (hazard ratio, 0.15; 95% confidence interval, 0.02-1.21).

Conclusion:

This multifactorial fall-prevention program does not reduce falls in high-risk, cognitively intact older persons. Trial Registration: isrctn.org Identifier: ISRCTN11546541.
Keyword Elderly-People
Prevention Program
Community
Metaanalysis
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
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