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Effect of a Risk-Based Multifactorial Fall Prevention Program on the Incidence of Falls

Authors

  • Marika J. Salminen PhD,

    1. From the *Departments of Family MedicineBiostatistics, Institute of Clinical Medicine, University of Turku, Turku, FinlandSatakunta Central Hospital, Pori, Finland; and §Unit of Family Medicine, Turku University Hospital, Turku, Finland.
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  • Tero J. Vahlberg MSc,

    1. From the *Departments of Family MedicineBiostatistics, Institute of Clinical Medicine, University of Turku, Turku, FinlandSatakunta Central Hospital, Pori, Finland; and §Unit of Family Medicine, Turku University Hospital, Turku, Finland.
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  • Maritta T. Salonoja MD,

    1. From the *Departments of Family MedicineBiostatistics, Institute of Clinical Medicine, University of Turku, Turku, FinlandSatakunta Central Hospital, Pori, Finland; and §Unit of Family Medicine, Turku University Hospital, Turku, Finland.
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  • Pertti T.T. Aarnio MD, PhD,

    1. From the *Departments of Family MedicineBiostatistics, Institute of Clinical Medicine, University of Turku, Turku, FinlandSatakunta Central Hospital, Pori, Finland; and §Unit of Family Medicine, Turku University Hospital, Turku, Finland.
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  • Sirkka-Liisa Kivelä MD, PhD

    1. From the *Departments of Family MedicineBiostatistics, Institute of Clinical Medicine, University of Turku, Turku, FinlandSatakunta Central Hospital, Pori, Finland; and §Unit of Family Medicine, Turku University Hospital, Turku, Finland.
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Address correspondence to Marika J. Salminen, Family Medicine, Lemminkäisenkatu 1, FI-20014, University of Turku, Turku, Finland. E-mail: majosa@utu.fi

Abstract

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.

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