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.