Effectiveness of a multifactorial intervention program to reduce falls incidence among community-living older adults: A randomized controlled trial

Abstract

Pérula LA, Varas-Fabra F, Rodríguez V, Ruiz-Moral R, Fernández JA, González J, Pérula CJ, Roldán AM, de Dios C, and the EPICA Study Collaborative Group. Effectiveness of a multifactorial intervention program to reduce falls incidence among community-living older adults: a randomized controlled trial. Objective: To determine the effectiveness of a multifactorial intervention program to prevent falls among older adults as compared with a brief intervention. Design: Randomized controlled trial. Setting: Eleven health centers located in Córdoba, Spain. Participants: People over 70 years old (N=404), who are residents in the community. Interventions: The centers were randomized to either 1 of the 2 groups: intervention group (IG), of a multifactorial nature (individual advice, information leaflet, physical exercise workshop, and home visits), or control group (CG) (brief individual advice and information leaflet). Main Outcome Measures: Fall rates and time until the fall; estimates of the relative and absolute risk of falls; and survival analysis and Cox regression. Results: Of the patients recruited, 133 were in the IG and 271 were in the CG. Around 33% in the IG and 30.25% in the CG had had a fall in the previous year (P=.56). After 12 months, the fall incidence rate was 17.29% in the IG and 23.61% in the CG (relative risk=0.73; 95% confidence interval [CI], 0.48-1.12; P=.146). Around 60% of the IG patients said they had increased the time spent on physical activity. In the IG, the incidence of falls at home was 27.5% compared with 49.3% in the CG (P=.04). Being a woman (odds ratio [OR]=1.62; 95% CI, 1.03-2.54), having a history of falls (OR=1.15; 95% CI, 1.05-1.26), suffering acute health problems (OR=2.19; 95% CI, 1.09-4.40), and doing moderate exercise (OR=1.91; 95% CI, 1.08-3.38) were found as factors associated with a higher risk of falls. Conclusions: Although the reduction of falls in the IG was nearly halved, and after the intervention there was a significant reduction in the number of falls at these patients' homes, the multifactorial intervention program is no more effective than the brief intervention to reduce the overall risk of falls. © 2012 American Congress of Rehabilitation Medicine.