Citation

Pérula LA, Varas-Fabra F, Rodríguez V, Ruiz-Moral R, Fernández JA, González J, Pérul CJ, Roldán AM, de Dios C. Arch. Phys. Med. Rehabil. 2012; 93(10): 1677-1684.

Affiliation

Unidad Docente de Medicina Familiar y Comunitaria de Córdoba Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/ University of Córdoba. Andalusian Health Service (SAS). Córdoba, Spain.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.apmr.2012.03.035

PMID

22609117

Abstract

OBJECTIVE: To determine the effectiveness of a multifactorial intervention program to prevent falls among the elderly as compared to a brief intervention. DESIGN: Randomized controlled trial. SETTING: 11 Health Centers located in Córdoba (Spain). PARTICIPANTS: People over 69 years old, residents in the community. INTERVENTIONS: The centers were randomized to either one 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. Survival analysis and Cox regression. RESULTS: 414 patients were recruited, 133 in the IG and 271 in the CG. 33.1% in the IG and 30.25% in the CG had had some fall the previous year (p= 0.56). After 12 months, the fall incidence rate was 17.29% in the IG and 23.61% in the CG (RR=0.73; 95%CI:0.48-1.12; (p=0.146). 60.1% of the IG patients said they had increased the time spent on physical activity. In the IG, the incidence of falls at homes was 27.5% compared to 49.3% in the CG (p=0.04). Being a woman (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.

Language: en