Effect of a risk-based multifactorial fall prevention program on the incidence of falls.
OBJECTIVE
To evaluate the effects of a multifactorial fall prevention program on falls and to identify the subgroups that benefit the most.


METHODS
Randomized controlled trial.


METHODS
Community-dwelling subjects who had fallen at least once during the previous 12 months.


METHODS
Five hundred ninety-one subjects randomized into intervention (IG) (n=293) and control (CG) (n=298) groups.


METHODS
A multifactorial 12-month fall prevention program.


METHODS
Incidence of falls.


RESULTS
The intervention did not reduce the incidence of falls overall (incidence rate ratio (IRR) for IG vs CG=0.92, 95% confidence interval (CI)=0.72-1.19). In subgroup analyses, significant interactions between subgroups and groups (IG and CG) were found for depressive symptoms (P=.006), number of falls during the previous 12 months (P=.003), and self-perceived risk of falling (P=.045). The incidence of falls decreased in subjects with a higher number of depressive symptoms (IRR=0.50, 95% CI=0.28-0.88), whereas it increased in those with a lower number of depressive symptoms (IRR=1.20, 95% CI=0.92-1.57). The incidence of falls decreased also in those with at least three previous falls (IRR=0.59, 95% CI=0.38-0.91) compared to those with one or two previous falls (IRR=1.28, 95% CI=0.95-1.72). The intervention was also more effective in subjects with high self-perceived risk of falling (IRR=0.77, 95% CI=0.55-1.06) than in those with low self-perceived risk (IRR=1.28, 95% CI=0.88-1.86).


CONCLUSIONS
The program was not effective in reducing falls in the total sample of community-dwelling subjects with a history of falling, but the incidence of falls decreased in participants with a higher number of depressive symptoms and in those with at least three falls.
Salminen
Marika J
MJ
Department of Family Medicine, Institute of Clinical Medicine, University of Turku, Turku, Finland. majosa@utu.fi
Vahlberg
Tero J
TJ
Salonoja
Maritta T
MT
Aarnio
Pertti T T
PT
Kivelä
Sirkka-Liisa
SL
D000056:Accident Prevention / Q000379:methods*; D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D003863:Depression / Q000150:complications; D005260:Female; D005387:Finland; D006801:Humans; D015994:Incidence; D008297:Male; D012307:Risk Factors; D018709:Statistics, Nonparametric; D016896:Treatment Outcome