title: Kenosha County falls prevention study: a randomized, controlled trial of an intermediate-intensity, community-based multifactorial falls intervention.
abstract: OBJECTIVE
  To decrease the rate of falls in high-risk community-dwelling older adults.
  
  
  METHODS
  Randomized, controlled trial.
  
  
  METHODS
  Community-based.
  
  
  METHODS
  Three hundred forty-nine adults aged 65 and older with two falls in the previous year or one fall in the previous 2 years with injury or balance problems.
  
  
  METHODS
  Subjects received two in-home visits from a trained nurse or physical therapist who assessed falls risk factors using an algorithm. The intervention consisted of recommendations to the subject and their primary physician, referrals to physical therapy and other providers, 11 monthly telephone calls, and a balance exercise plan. Control subjects received a home safety assessment.
  
  
  METHODS
  The primary outcome was rate of falls per year in the community. Secondary outcomes included all-cause hospitalizations and nursing home admissions per year.
  
  
  RESULTS
  There was no difference in rate of falls between the intervention and control groups (rate ratio (RR)=0.81, P=.27). Nursing home days were fewer in the intervention group (10.3 vs 20.5 days, P=.04). Intervention subjects with a Mini-Mental State Examination (MMSE) score of 27 or less had a lower rate of falls (RR=0.55; P=.05) and, if they lived with someone, had fewer hospitalizations (RR=0.44, P=.05), nursing home admissions (RR=0.15, P=.003), and nursing home days (7.5 vs 58.2, P=.008).
  
  
  CONCLUSIONS
  This multifactorial intervention did not decrease falls in at-risk community-living adults but did decrease nursing home utilization. There was evidence of efficacy in the subgroup who had an MMSE score of 27 or less and lived with a caregiver, but validation is required.
authors.affiliation: Department of Medicine, Section of Geriatrics, School of Medicine and Public Health, University of Wisconsin Madison, Madison, Wisconsin, USA. jm2@medicine.wisc.edu
authors.forename: Jane E
authors.initials: JE
authors.lastname: Mahoney
authors.forename: Terry A
authors.initials: TA
authors.lastname: Shea
authors.forename: Robert
authors.initials: R
authors.lastname: Przybelski
authors.forename: LaVerne
authors.initials: L
authors.lastname: Jaros
authors.forename: Ronald
authors.initials: R
authors.lastname: Gangnon
authors.forename: Sandy
authors.initials: S
authors.lastname: Cech
authors.forename: Alice
authors.initials: A
authors.lastname: Schwalbe
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D015444:Exercise; D005260:Female; D005853:Geriatrics; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D004856:Postural Balance; D012307:Risk Factors; D014922:Wisconsin