Environmental Assessment and Modification to Prevent Falls in Older People

Authors

  • Alison C. Pighills PhD,

    1. From the *Martin Bland Department of Health Sciences, York Trials Unit, University of York, York, United Kingdom; §Division of Rehabilitation and Ageing, Nottingham University Medical School, Queens Medical Centre, Nottingham, United Kingdom.
    Search for more papers by this author
  • David J. Torgerson PhD,

    1. From the *Martin Bland Department of Health Sciences, York Trials Unit, University of York, York, United Kingdom; §Division of Rehabilitation and Ageing, Nottingham University Medical School, Queens Medical Centre, Nottingham, United Kingdom.
    Search for more papers by this author
  • Trevor A. Sheldon DSc,

    1. From the *Martin Bland Department of Health Sciences, York Trials Unit, University of York, York, United Kingdom; §Division of Rehabilitation and Ageing, Nottingham University Medical School, Queens Medical Centre, Nottingham, United Kingdom.
    Search for more papers by this author
  • Avril E. Drummond PhD,

    1. From the *Martin Bland Department of Health Sciences, York Trials Unit, University of York, York, United Kingdom; §Division of Rehabilitation and Ageing, Nottingham University Medical School, Queens Medical Centre, Nottingham, United Kingdom.
    Search for more papers by this author
  • J. Martin Bland PhD

    1. From the *Martin Bland Department of Health Sciences, York Trials Unit, University of York, York, United Kingdom; §Division of Rehabilitation and Ageing, Nottingham University Medical School, Queens Medical Centre, Nottingham, United Kingdom.
    Search for more papers by this author

Errata

This article is corrected by:

  1. Errata: ERRATUM Volume 59, Issue 4, 776, Article first published online: 14 April 2011

  • International trial number: ISRCTN07575807

Address correspondence to Alison C. Pighills, Clinical Lead for Rehabilitation, Bradford and Airedale Community Health Services, Douglas Mill, Bradford BD5 7JR, United Kingdom. E-mail: Alison_pighills@health.qld.gov.au

OBJECTIVES:

To assess the effectiveness of an environmental falls prevention intervention delivered by qualified occupational therapists or unqualified trained assessors.

DESIGN: A pilot three-armed randomized controlled trial.

SETTING: Airedale National Health Service Trust catchment, North and West Yorkshire, England.

PARTICIPANTS: Two hundred thirty-eight community-dwelling adults aged 70 and older with a history of falls in the previous year.

INTERVENTION: Assessment and modification of the home environment of people at greater risk of falls.

MEASUREMENTS: Fear of falling was the primary outcome measure, and an analysis of covariance was conducted on the area under the curve at 12 months. As a secondary outcome, falls were analysed using negative binomial regression. Quality of life and independence in activities of daily living (ADLs) were also measured.

RESULTS: The intervention had no effect on fear of falling (P=.63). The occupational therapy group had significantly fewer falls than controls 12 months after the assessment (incidence rate ratio (IRR)=0.54, 95% confidence interval (CI)=0.36–0.83, P=.005). There was no significant effect on falls in the trained assessor group (IRR=0.78, 95% CI=0.51–1.21, P=.34).

CONCLUSION: Environmental assessment had no effect on fear of falling. Environmental assessment prescribed by an occupational therapist significantly reduced the number of falls in high-risk individuals whereas that prescribed by a trained assessor did not. Further research in other settings is needed to confirm this, to explore the mechanisms, and to estimate cost-effectiveness.

Ancillary