Multifactorial intervention to reduce falls in older people at high risk of recurrent falls: a randomized controlled trial

O.J. de Vries, G.M.E.E. Peeters, P.J.M. Elders, M.T. Muller, D.L. Knol, S.A. Danner, L.M. Bouter, P.T.A.M. Lips

    Research output: Contribution to JournalArticleAcademicpeer-review

    Abstract

    Background: Falls occur frequently in older people and strongly affect quality of life. Guidelines recommend multifactorial, targeted fall prevention. We evaluated the effectiveness of a multifactorial intervention in older persons with a high risk of recurrent falls. Methods: A randomized controlled trial was conducted from April 3, 2005, to July 21, 2008, at the geriatric outpatient clinic of a university hospital and regional general practices in the Netherlands. Of 2015 persons identified, 217 persons aged 65 years or older were selected to participate. They had a high risk of recurrent falls and no cognitive impairment and had visited the emergency department or their family physician after a fall. The geriatric assessment and intervention were aimed at reduction of fall risk factors. Primary outcome measures were time to first and second falls after randomization. Secondary outcome measures were fractures, activities of daily living, quality of life, and physical performance. Results: Within 1 year, 55 (51.9%) of the 106 intervention participants and 62 (55.9%) of the 111 usual care (control) participants fell at least once. No significant treatment effect was demonstrated for the time to first fall (hazard ratio, 0.96; 95% confidence interval, 0.67-1.37) or the time to second fall (1.13; 0.71-1.80). Similar results were obtained for secondary outcome measures and for perprotocol analysis. One intervention participant died vs 7 in the control group (hazard ratio, 0.15; 95% confidence interval, 0.02-1.21). Conclusion: This multifactorial fall-prevention program does not reduce falls in high-risk, cognitively intact older persons. Trial Registration: isrctn.org Identifier: ISRCTN11546541. ©2010 American Medical Association. All rights reserved.
    Original languageEnglish
    Pages (from-to)1110-1117
    Number of pages8
    JournalArchives of Internal Medicine
    Volume170
    Issue number13
    DOIs
    Publication statusPublished - 2010

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    Randomized Controlled Trials
    Outcome Assessment (Health Care)
    Quality of Life
    Confidence Intervals
    Geriatric Assessment
    Family Physicians
    American Medical Association
    Activities of Daily Living
    Random Allocation
    Ambulatory Care Facilities
    General Practice
    Geriatrics
    Netherlands
    Hospital Emergency Service
    Guidelines
    Control Groups
    Therapeutics

    Cite this

    de Vries, O. J., Peeters, G. M. E. E., Elders, P. J. M., Muller, M. T., Knol, D. L., Danner, S. A., ... Lips, P. T. A. M. (2010). Multifactorial intervention to reduce falls in older people at high risk of recurrent falls: a randomized controlled trial. Archives of Internal Medicine, 170(13), 1110-1117. https://doi.org/10.1001/archinternmed.2010.169
    de Vries, O.J. ; Peeters, G.M.E.E. ; Elders, P.J.M. ; Muller, M.T. ; Knol, D.L. ; Danner, S.A. ; Bouter, L.M. ; Lips, P.T.A.M. / Multifactorial intervention to reduce falls in older people at high risk of recurrent falls: a randomized controlled trial. In: Archives of Internal Medicine. 2010 ; Vol. 170, No. 13. pp. 1110-1117.
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    title = "Multifactorial intervention to reduce falls in older people at high risk of recurrent falls: a randomized controlled trial",
    abstract = "Background: Falls occur frequently in older people and strongly affect quality of life. Guidelines recommend multifactorial, targeted fall prevention. We evaluated the effectiveness of a multifactorial intervention in older persons with a high risk of recurrent falls. Methods: A randomized controlled trial was conducted from April 3, 2005, to July 21, 2008, at the geriatric outpatient clinic of a university hospital and regional general practices in the Netherlands. Of 2015 persons identified, 217 persons aged 65 years or older were selected to participate. They had a high risk of recurrent falls and no cognitive impairment and had visited the emergency department or their family physician after a fall. The geriatric assessment and intervention were aimed at reduction of fall risk factors. Primary outcome measures were time to first and second falls after randomization. Secondary outcome measures were fractures, activities of daily living, quality of life, and physical performance. Results: Within 1 year, 55 (51.9{\%}) of the 106 intervention participants and 62 (55.9{\%}) of the 111 usual care (control) participants fell at least once. No significant treatment effect was demonstrated for the time to first fall (hazard ratio, 0.96; 95{\%} confidence interval, 0.67-1.37) or the time to second fall (1.13; 0.71-1.80). Similar results were obtained for secondary outcome measures and for perprotocol analysis. One intervention participant died vs 7 in the control group (hazard ratio, 0.15; 95{\%} confidence interval, 0.02-1.21). Conclusion: This multifactorial fall-prevention program does not reduce falls in high-risk, cognitively intact older persons. Trial Registration: isrctn.org Identifier: ISRCTN11546541. {\circledC}2010 American Medical Association. All rights reserved.",
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    Multifactorial intervention to reduce falls in older people at high risk of recurrent falls: a randomized controlled trial. / de Vries, O.J.; Peeters, G.M.E.E.; Elders, P.J.M.; Muller, M.T.; Knol, D.L.; Danner, S.A.; Bouter, L.M.; Lips, P.T.A.M.

    In: Archives of Internal Medicine, Vol. 170, No. 13, 2010, p. 1110-1117.

    Research output: Contribution to JournalArticleAcademicpeer-review

    TY - JOUR

    T1 - Multifactorial intervention to reduce falls in older people at high risk of recurrent falls: a randomized controlled trial

    AU - de Vries, O.J.

    AU - Peeters, G.M.E.E.

    AU - Elders, P.J.M.

    AU - Muller, M.T.

    AU - Knol, D.L.

    AU - Danner, S.A.

    AU - Bouter, L.M.

    AU - Lips, P.T.A.M.

    PY - 2010

    Y1 - 2010

    N2 - Background: Falls occur frequently in older people and strongly affect quality of life. Guidelines recommend multifactorial, targeted fall prevention. We evaluated the effectiveness of a multifactorial intervention in older persons with a high risk of recurrent falls. Methods: A randomized controlled trial was conducted from April 3, 2005, to July 21, 2008, at the geriatric outpatient clinic of a university hospital and regional general practices in the Netherlands. Of 2015 persons identified, 217 persons aged 65 years or older were selected to participate. They had a high risk of recurrent falls and no cognitive impairment and had visited the emergency department or their family physician after a fall. The geriatric assessment and intervention were aimed at reduction of fall risk factors. Primary outcome measures were time to first and second falls after randomization. Secondary outcome measures were fractures, activities of daily living, quality of life, and physical performance. Results: Within 1 year, 55 (51.9%) of the 106 intervention participants and 62 (55.9%) of the 111 usual care (control) participants fell at least once. No significant treatment effect was demonstrated for the time to first fall (hazard ratio, 0.96; 95% confidence interval, 0.67-1.37) or the time to second fall (1.13; 0.71-1.80). Similar results were obtained for secondary outcome measures and for perprotocol analysis. One intervention participant died vs 7 in the control group (hazard ratio, 0.15; 95% confidence interval, 0.02-1.21). Conclusion: This multifactorial fall-prevention program does not reduce falls in high-risk, cognitively intact older persons. Trial Registration: isrctn.org Identifier: ISRCTN11546541. ©2010 American Medical Association. All rights reserved.

    AB - Background: Falls occur frequently in older people and strongly affect quality of life. Guidelines recommend multifactorial, targeted fall prevention. We evaluated the effectiveness of a multifactorial intervention in older persons with a high risk of recurrent falls. Methods: A randomized controlled trial was conducted from April 3, 2005, to July 21, 2008, at the geriatric outpatient clinic of a university hospital and regional general practices in the Netherlands. Of 2015 persons identified, 217 persons aged 65 years or older were selected to participate. They had a high risk of recurrent falls and no cognitive impairment and had visited the emergency department or their family physician after a fall. The geriatric assessment and intervention were aimed at reduction of fall risk factors. Primary outcome measures were time to first and second falls after randomization. Secondary outcome measures were fractures, activities of daily living, quality of life, and physical performance. Results: Within 1 year, 55 (51.9%) of the 106 intervention participants and 62 (55.9%) of the 111 usual care (control) participants fell at least once. No significant treatment effect was demonstrated for the time to first fall (hazard ratio, 0.96; 95% confidence interval, 0.67-1.37) or the time to second fall (1.13; 0.71-1.80). Similar results were obtained for secondary outcome measures and for perprotocol analysis. One intervention participant died vs 7 in the control group (hazard ratio, 0.15; 95% confidence interval, 0.02-1.21). Conclusion: This multifactorial fall-prevention program does not reduce falls in high-risk, cognitively intact older persons. Trial Registration: isrctn.org Identifier: ISRCTN11546541. ©2010 American Medical Association. All rights reserved.

    U2 - 10.1001/archinternmed.2010.169

    DO - 10.1001/archinternmed.2010.169

    M3 - Article

    VL - 170

    SP - 1110

    EP - 1117

    JO - Archives of Internal Medicine

    JF - Archives of Internal Medicine

    SN - 0003-9926

    IS - 13

    ER -