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Randomized Controlled Trial
. 2014 Feb 25:9:383-93.
doi: 10.2147/CIA.S57580. eCollection 2014.

Multifactorial assessment and targeted intervention to reduce falls among the oldest-old: a randomized controlled trial

Assumpta Ferrer  1 , Francesc Formiga  2 , Héctor Sanz  3 , Oscar J de Vries  4 , Teresa Badia  5 , Ramón Pujol  2 ; OCTABAIX Study Group
Collaborators, Affiliations
Randomized Controlled Trial

Multifactorial assessment and targeted intervention to reduce falls among the oldest-old: a randomized controlled trial

Assumpta Ferrer et al. Clin Interv Aging. .

Abstract

Background: The purpose of this study was to assess the effectiveness of a multifactorial intervention to reduce falls among the oldest-old people, including individuals with cognitive impairment or comorbidities.

Methods: A randomized, single-blind, parallel-group clinical trial was conducted from January 2009 to December 2010 in seven primary health care centers in Baix Llobregat (Barcelona). Of 696 referred people who were born in 1924, 328 were randomized to an intervention group or a control group. The intervention model used an algorithm and was multifaceted for both patients and their primary care providers. Primary outcomes were risk of falling and time until falls. Data analyses were by intention-to-treat.

Results: Sixty-five (39.6%) subjects in the intervention group and 48 (29.3%) in the control group fell during follow-up. The difference in the risk of falls was not significant (relative risk 1.28, 95% confidence interval [CI] 0.94-1.75). Cox regression models with time from randomization to the first fall were not significant. Cox models for recurrent falls showed that intervention had a negative effect (hazard ratio [HR] 1.46, 95% CI 1.03-2.09) and that functional impairment (HR 1.42, 95% CI 0.97-2.12), previous falls (HR 1.09, 95% CI 0.74-1.60), and cognitive impairment (HR 1.08, 95% CI 0.72-1.60) had no effect on the assessment.

Conclusion: This multifactorial intervention among octogenarians, including individuals with cognitive impairment or comorbidities, did not result in a reduction in falls. A history of previous falls, disability, and cognitive impairment had no effect on the program among the community-dwelling subjects in this study.

Trial registration: ClinicalTrials.gov NCT01141166.

Keywords: elderly; falls; intervention.

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Figures

Figure 1
Figure 1
Flow chart of participants throughout the trial.
Figure 2
Figure 2
Comparison of Kaplan–Meier survival curves for time to first and second fall between control and intervention group over 2 years of follow-up.
See this image and copyright information in PMC

References

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