A multifactorial fall prevention programme in the community-dwelling aged: predictors of adherence.
BACKGROUND
Overall adherence rates have usually been reported in fall prevention studies, but predictors of adherence have rarely been described. The aim of this study was to determine the adherence rates and the predictors of adherence in four key activities of a multifactorial fall prevention trial.


METHODS
This study is part of a multifactorial fall prevention programme implemented among the 65-year-old or older community-dwelling aged who had fallen at least once during the previous 12 months. Subjects (n = 591) were randomly assigned to an intensive prevention programme or to a counselling group. Four key activities of prevention programme included physical exercise in small groups, psychosocial group activities, lectures and home exercises. Associations between adherence rates and potential predictors were analysed using cumulative logistic regression.


RESULTS
The mean adherence rate was 58% in the physical exercise groups, 25% in the psychosocial groups and 33% in lectures. Subjects performed home-exercises on average 11 times per month. In multivariate analyses, infrequent feelings of loneliness, low self-perceived probability of falling at home and good physical functional abilities were significant predictors of active physical exercise group adherence. Good physical and cognitive functional abilities predicted active psychosocial group adherence. Female gender and good physical and cognitive functional abilities predicted more active lecture adherence.


CONCLUSIONS
Persons with the poorest physical, cognitive and psychological functional abilities representing the part of the population at highest risk of falling do not seem reachable in multifactorial risk-based intervention.
Sjösten
Noora Maria
NM
The Institute of Clinical Medicine, Family Medicine, University of Turku, Turku, Finland. nookau@utu.fi
Salonoja
Maritta
M
Piirtola
Maarit
M
Vahlberg
Tero Juhani
TJ
Isoaho
Raimo
R
Hyttinen
Hanna Kristiina
HK
Aarnio
Pertti Toivo
PT
Kivelä
Sirkka-Liisa
SL
D000058:Accidental Falls / Q000517:prevention & control*; D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D003376:Counseling / Q000706:statistics & numerical data*; D015444:Exercise; D005260:Female; D005387:Finland; D016330:Frail Elderly / Q000523:psychology*; D015577:Geriatric Assessment; D006126:Group Processes; D006293:Health Promotion / Q000379:methods*; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D008499:Medical Records; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D015397:Program Evaluation; D018570:Risk Assessment; D020377:Self Efficacy