Effect of a Risk-Based Multifactorial Fall Prevention Program on the Incidence of Falls
Article first published online: 17 MAR 2009
© 2009, Copyright the Authors. Journal compilation © 2009, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 57, Issue 4, pages 612–619, April 2009
How to Cite
Salminen, M. J., Vahlberg, T. J., Salonoja, M. T., Aarnio, P. T.T. and Kivelä, S.-L. (2009), Effect of a Risk-Based Multifactorial Fall Prevention Program on the Incidence of Falls. Journal of the American Geriatrics Society, 57: 612–619. doi: 10.1111/j.1532-5415.2009.02176.x
- Issue published online: 2 APR 2009
- Article first published online: 17 MAR 2009
- fall prevention;
OBJECTIVES: To evaluate the effects of a multifactorial fall prevention program on falls and to identify the subgroups that benefit the most.
DESIGN: Randomized controlled trial.
SETTING: Community-dwelling subjects who had fallen at least once during the previous 12 months.
PARTICIPANTS: Five hundred ninety-one subjects randomized into intervention (IG) (n=293) and control (CG) (n=298) groups.
INTERVENTION: A multifactorial 12-month fall prevention program.
MEASUREMENTS: Incidence of falls.
RESULTS: The intervention did not reduce the incidence of falls overall (incidence rate ratio (IRR) for IG vs CG=0.92, 95% confidence interval (CI)=0.72–1.19). In subgroup analyses, significant interactions between subgroups and groups (IG and CG) were found for depressive symptoms (P=.006), number of falls during the previous 12 months (P=.003), and self-perceived risk of falling (P=.045). The incidence of falls decreased in subjects with a higher number of depressive symptoms (IRR=0.50, 95% CI=0.28–0.88), whereas it increased in those with a lower number of depressive symptoms (IRR=1.20, 95% CI=0.92–1.57). The incidence of falls decreased also in those with at least three previous falls (IRR=0.59, 95% CI=0.38–0.91) compared to those with one or two previous falls (IRR=1.28, 95% CI=0.95–1.72). The intervention was also more effective in subjects with high self-perceived risk of falling (IRR=0.77, 95% CI=0.55–1.06) than in those with low self-perceived risk (IRR=1.28, 95% CI=0.88–1.86).
CONCLUSION: The program was not effective in reducing falls in the total sample of community-dwelling subjects with a history of falling, but the incidence of falls decreased in participants with a higher number of depressive symptoms and in those with at least three falls.