International trial number: ISRCTN07575807
Environmental Assessment and Modification to Prevent Falls in Older People
Article first published online: 13 JAN 2011
© 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 59, Issue 1, pages 26–33, January 2011
How to Cite
Pighills, A. C., Torgerson, D. J., Sheldon, T. A., Drummond, A. E. and Bland, J. M. (2011), Environmental Assessment and Modification to Prevent Falls in Older People. Journal of the American Geriatrics Society, 59: 26–33. doi: 10.1111/j.1532-5415.2010.03221.x
- Issue published online: 13 JAN 2011
- Article first published online: 13 JAN 2011
Vol. 59, Issue 4, 776, Article first published online: 14 APR 2011
- fear of falling;
- older people;
- occupational therapy;
- home assessment
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.