Preventing disability and falls in older adults: a population-based randomized trial.
OBJECTIVE
Because preventing disability and falls in older adults is a national priority, a randomized controlled trial was conducted to test a multicomponent intervention program.


METHODS
From a random sample of health maintenance organization (HMO) enrollees 65 years and older, 1559 ambulatory seniors were randomized to one of three groups: a nurse assessment visit and follow-up interventions targeting risk factors for disability and falls (group 1, n = 635); a general health promotion nurse visit (group 2, n = 317); and usual care (group 3, n = 607). Data collection consisted of a baseline and two annual follow-up surveys.


RESULTS
After 1 year, group 1 subjects reported a significantly lower incidence of declining functional status and a significantly lower incidence of falls than group 3 subjects. Group 2 subjects had intermediate levels of most outcomes. After 2 years of follow-up, the differences narrowed.


CONCLUSIONS
The results suggest that a modest, one-time prevention program appeared to confer short-term health benefits on ambulatory HMO enrollees, although benefits diminished by the second year of follow-up. The mechanisms by which the intervention may have improved outcomes require further investigation.
Wagner
E H
EH
Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA 98101.
LaCroix
A Z
AZ
Grothaus
L
L
Leveille
S G
SG
Hecht
J A
JA
Artz
K
K
Odle
K
K
Buchner
D M
DM
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006279:Health Maintenance Organizations; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D015994:Incidence; D008297:Male; D009730:Nursing Assessment / Q000458:organization & administration*; D015397:Program Evaluation; D012307:Risk Factors