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 control...
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| creator | Pérula, Luis A., MD Varas-Fabra, Francisco, MD Rodríguez, Victoriano, MD Ruiz-Moral, Roger, MD Fernández, José A., MD González, Jesús, MD Pérula, Carlos J., RN Roldán, Ana M., MD de Dios, Caridad, RN |
| description | 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. |
| doi_str_mv | 10.1016/j.apmr.2012.03.035 |
| format | Article |
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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.</description><identifier>ISSN: 0003-9993</identifier><identifier>EISSN: 1532-821X</identifier><identifier>DOI: 10.1016/j.apmr.2012.03.035</identifier><identifier>PMID: 22609117</identifier><identifier>CODEN: APMHAI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Accident Prevention - methods ; Accidental falls ; Accidental Falls - prevention & control ; Accidents, Home - prevention & control ; Activities of Daily Living ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Chi-Square Distribution ; Diseases of the osteoarticular system ; Exercise ; Female ; Humans ; Male ; Medical sciences ; Miscellaneous ; Physical Medicine and Rehabilitation ; Proportional Hazards Models ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Rehabilitation ; Risk Factors ; Spain ; Surveys and Questionnaires</subject><ispartof>Archives of physical medicine and rehabilitation, 2012-10, Vol.93 (10), p.1677-1684</ispartof><rights>American Congress of Rehabilitation Medicine</rights><rights>2012 American Congress of Rehabilitation Medicine</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c507t-f5a21b92357c82ac524e402212973543a5510b87e58b1dad03a83aa8f4e7560e3</citedby><cites>FETCH-LOGICAL-c507t-f5a21b92357c82ac524e402212973543a5510b87e58b1dad03a83aa8f4e7560e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0003999312003267$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26399469$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22609117$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pérula, Luis A., MD</creatorcontrib><creatorcontrib>Varas-Fabra, Francisco, MD</creatorcontrib><creatorcontrib>Rodríguez, Victoriano, MD</creatorcontrib><creatorcontrib>Ruiz-Moral, Roger, MD</creatorcontrib><creatorcontrib>Fernández, José A., MD</creatorcontrib><creatorcontrib>González, Jesús, MD</creatorcontrib><creatorcontrib>Pérula, Carlos J., RN</creatorcontrib><creatorcontrib>Roldán, Ana M., MD</creatorcontrib><creatorcontrib>de Dios, Caridad, RN</creatorcontrib><creatorcontrib>EPICA Study Collaborative Group</creatorcontrib><title>Effectiveness of a Multifactorial Intervention Program to Reduce Falls Incidence Among Community-Living Older Adults: A Randomized Controlled Trial</title><title>Archives of physical medicine and rehabilitation</title><addtitle>Arch Phys Med Rehabil</addtitle><description>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.</description><subject>Accident Prevention - methods</subject><subject>Accidental falls</subject><subject>Accidental Falls - prevention & control</subject><subject>Accidents, Home - prevention & control</subject><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Chi-Square Distribution</subject><subject>Diseases of the osteoarticular system</subject><subject>Exercise</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Miscellaneous</subject><subject>Physical Medicine and Rehabilitation</subject><subject>Proportional Hazards Models</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Rehabilitation</subject><subject>Risk Factors</subject><subject>Spain</subject><subject>Surveys and Questionnaires</subject><issn>0003-9993</issn><issn>1532-821X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks2KFDEQxxtR3HX1BTxILoKXHvPR6Q8RYRh2dWFkZV3BW8gk1UvGdDIm3QPja_jCVjOjggehIFXJr6rCv6oonjO6YJTVr7cLvRvSglPGF1SgyQfFOZOCly1nXx8W55RSUXZdJ86KJzlvMaylYI-LM85r2jHWnBc_L_sezOj2ECBnEnuiycfJj67XZozJaU-uwwgJ30cXA_mU4n3SAxkjuQU7GSBX2vuMkHEWAsbLIYZ7sorDMAU3Hsq12zu8uPEWEllarJ3fkCW51cHGwf0Ai2wYU_Qe3bu549PiUa99hmen86L4cnV5t_pQrm_eX6-W69JI2oxlLzVnm44L2ZiWayN5BRXlnPGuEbISWkpGN20Dst0wqy0VuhVat30FjawpiIvi1bHuLsXvE-RRDS4b8F4HiFNWjFZMcClpiyg_oibFnBP0apfcoNMBITUPQ23VPAw1D0NRgSYx6cWp_rQZwP5J-a0-Ai9PgM5G-z5pVDH_5WrRdVXdIff2yAGqsXeQVDZuFtu6hMNTNrr__-PdP-nGu-Cw4zc4QN7GKQXUWTGVMUd9ntdm3hrG0eF1I34Be1O90g</recordid><startdate>20121001</startdate><enddate>20121001</enddate><creator>Pérula, Luis A., MD</creator><creator>Varas-Fabra, Francisco, MD</creator><creator>Rodríguez, Victoriano, MD</creator><creator>Ruiz-Moral, Roger, MD</creator><creator>Fernández, José A., MD</creator><creator>González, Jesús, MD</creator><creator>Pérula, Carlos J., RN</creator><creator>Roldán, Ana M., MD</creator><creator>de Dios, Caridad, RN</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20121001</creationdate><title>Effectiveness of a Multifactorial Intervention Program to Reduce Falls Incidence Among Community-Living Older Adults: A Randomized Controlled Trial</title><author>Pérula, Luis A., MD ; Varas-Fabra, Francisco, MD ; Rodríguez, Victoriano, MD ; Ruiz-Moral, Roger, MD ; Fernández, José A., MD ; González, Jesús, MD ; Pérula, Carlos J., RN ; Roldán, Ana M., MD ; de Dios, Caridad, RN</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c507t-f5a21b92357c82ac524e402212973543a5510b87e58b1dad03a83aa8f4e7560e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Accident Prevention - methods</topic><topic>Accidental falls</topic><topic>Accidental Falls - prevention & control</topic><topic>Accidents, Home - prevention & control</topic><topic>Activities of Daily Living</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Chi-Square Distribution</topic><topic>Diseases of the osteoarticular system</topic><topic>Exercise</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Miscellaneous</topic><topic>Physical Medicine and Rehabilitation</topic><topic>Proportional Hazards Models</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Rehabilitation</topic><topic>Risk Factors</topic><topic>Spain</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pérula, Luis A., MD</creatorcontrib><creatorcontrib>Varas-Fabra, Francisco, MD</creatorcontrib><creatorcontrib>Rodríguez, Victoriano, MD</creatorcontrib><creatorcontrib>Ruiz-Moral, Roger, MD</creatorcontrib><creatorcontrib>Fernández, José A., MD</creatorcontrib><creatorcontrib>González, Jesús, MD</creatorcontrib><creatorcontrib>Pérula, Carlos J., RN</creatorcontrib><creatorcontrib>Roldán, Ana M., MD</creatorcontrib><creatorcontrib>de Dios, Caridad, RN</creatorcontrib><creatorcontrib>EPICA Study Collaborative Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of physical medicine and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pérula, Luis A., MD</au><au>Varas-Fabra, Francisco, MD</au><au>Rodríguez, Victoriano, MD</au><au>Ruiz-Moral, Roger, MD</au><au>Fernández, José A., MD</au><au>González, Jesús, MD</au><au>Pérula, Carlos J., RN</au><au>Roldán, Ana M., MD</au><au>de Dios, Caridad, RN</au><aucorp>EPICA Study Collaborative Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of a Multifactorial Intervention Program to Reduce Falls Incidence Among Community-Living Older Adults: A Randomized Controlled Trial</atitle><jtitle>Archives of physical medicine and rehabilitation</jtitle><addtitle>Arch Phys Med Rehabil</addtitle><date>2012-10-01</date><risdate>2012</risdate><volume>93</volume><issue>10</issue><spage>1677</spage><epage>1684</epage><pages>1677-1684</pages><issn>0003-9993</issn><eissn>1532-821X</eissn><coden>APMHAI</coden><abstract>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.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>22609117</pmid><doi>10.1016/j.apmr.2012.03.035</doi><tpages>8</tpages></addata></record> |
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| subjects | Accident Prevention - methods Accidental falls Accidental Falls - prevention & control Accidents, Home - prevention & control Activities of Daily Living Aged Aged, 80 and over Biological and medical sciences Chi-Square Distribution Diseases of the osteoarticular system Exercise Female Humans Male Medical sciences Miscellaneous Physical Medicine and Rehabilitation Proportional Hazards Models Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Rehabilitation Risk Factors Spain Surveys and Questionnaires |
| title | Effectiveness of a Multifactorial Intervention Program to Reduce Falls Incidence Among Community-Living Older Adults: A Randomized Controlled Trial |
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