Effectiveness of a multifaceted intervention on falls in nursing home residents.
OBJECTIVE
To evaluate the effectiveness of a multifaceted, nonpharmaceutical intervention on incidence of falls and fallers.


METHODS
Prospective, cluster-randomized, controlled 12-month trial.


METHODS
Six community nursing homes in Germany.


METHODS
Long-stay residents (n = 981) aged 60 and older; mean age 85; 79% female.


METHODS
Staff and resident education on fall prevention, advice on environmental adaptations, progressive balance and resistance training, and hip protectors.


METHODS
Falls, fallers, and fractures.


RESULTS
The incidence density rate of falls per 1,000 resident years (RY) was 2,558 for the control group (CG) and 1,399 for the intervention group (IG) (relative risk (RR) = 0.55, 95% confidence interval (CI) = 0.41-0.73). Two hundred forty-seven (52.3%) fallers were detected in the CG and 188 (36.9%) in the IG (RR = 0.75, 95% CI = 0.57-0.98). The incidence density rate of frequent fallers (>2/year) was 115 (24.4%) for the CG and 66 (13.0%) for the IG (RR = 0.56, 95% CI = 0.35-0.89). The incidence density rate of hip fractures per 1,000 RY was 39 for the CG and 43 for the IG (RR = 1.11, 95% CI = 0.49-2.51). Other fractures were diagnosed with an incidence density rate of 52 per 1,000 RY for CG and 41 per 1,000 RY for IG (RR = 0.78, 95% CI = 0.57-1.07).


CONCLUSIONS
The incidence density rate of falls and fallers differed considerably between the control and intervention groups. The study was underpowered to demonstrate a significant difference of hip or nonhip fractures. Because of a low fracture rate in both groups, the investigation of fracture rates would have required a larger sample size to detect an effect of the intervention.
Becker
Clemens
C
Bethesda Geriatric Clinic, Academic Center at the University of Ulm, Zollernring 26-28, D-89073 Ulm, Germany. clemens.becker@medizin.uni-ulm.de
Kron
Martina
M
Lindemann
Ulrich
U
Sturm
Elisabeth
E
Eichner
Barbara
B
Walter-Jung
Barbara
B
Nikolaus
Thorsten
T
D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes; D011446:Prospective Studies