The population approach to falls injury prevention in older people: findings of a two community trial

Abstract

Background: There is a sound rationale for the population-based approach to falls injury prevention but there is currently insufficient evidence to advise governments and communities on how they can use population-based strategies to achieve desired reductions in the burden of falls-related injury. The aim of the study was to quantify the effectiveness of a streamlined (and thus potentially sustainable and cost-effective), population-based, multi-factorial falls injury prevention program for people over 60 years of age.

Methods: Population-based falls-prevention interventions were conducted at two geographically-defined and separate Australian sites: Wide Bay, Queensland, and Northern Rivers, NSW. Changes in the prevalence of key risk factors and changes in rates of injury outcomes within each community were compared before and after program implementation and changes in rates of injury outcomes in each community were also compared with the rates in their respective States.

Results: The interventions in neither community substantially decreased the rate of falls-related injury among people aged 60 years or older, although there was some evidence of reductions in occurrence of multiple falls reported by women. In addition, there was some indication of improvements in fall-related risk factors, but the magnitudes were generally modest.

Conclusions: The evidence suggests that low intensity population-based falls prevention programs may not be as effective as those that are intensively implemented.

Figure 1

Mortality rates for fall or related fracture as underlying or contributory cause of death for adults aged 60 years or older in Wide Bay (Wide Bay) and Northern Rivers (Northern Rivers) regions in comparison to statewide rates for Queensland (Qld) and New South Wales (NSW) **. ** Used the average of the Australia population between 1997 and 2004 for standardisation of rates (60-, 65-, 70-, 75-, 80-, 85+ years)

Figure 2

Hospitalisation rates for fall or related fracture for adults aged 60 years or older in Wide Bay (Wide Bay) and Northern Rivers (Northern Rivers) regions in comparison to statewide rates for Queensland (Qld) and New South Wales (NSW) **. ** Used the average of the Australia population between 1997 and 2004 for standardisation of rates (60-, 65-, 70-, 75-, 80+ years)