Falls Clinics: an opportunity to address frailty and improve health outcomes (preliminary evidence).
OBJECTIVE
Currently the operational model of a Falls Clinic is not clearly defined making it difficult to assess outcomes. Predominantly referrals are for older, frail adults and while there is merit in current interventions prescribed the effect on falls and other outcomes over time are unclear. The aim of this pilot study is to describe 12 month health outcomes of community-dwelling older adults who have attended a multi-disciplinary Falls Clinic.


METHODS
A sequential sample of 90 community-dwelling older adults (> or =65 years) attending a Falls and Injury Risk Assessment Clinic between April and October 2001 was followed-up at 12 months. Outcomes included grip strength, Timed- Up and Go, body weight, number of fallers, and change in accommodation. Data are summarised as mean (SD) and n (%) with change over time tested using paired sample t-tests (continuous data) and chi-square (categorical data).


RESULTS
Sixty-five participants were available at 12 months. Mean (SD) age of participants was 80 (6) years and 30 of 65 (46%) were males. At 12 months, 62 (96%) remained in the same accommodation, 37 out of 65 (57%) reported >1 fall in the previous year, compared to 72% (n=47) on average at baseline (p=0.21). Grip strength (p=0.006), TUG (p=0.001) and body weight (p=0.033) all declined between baseline and 12 months.


CONCLUSIONS
This pilot study found a trend for reduction in falls, but this was accompanied with a significant decline in measures of frailty, including outcomes of nutritional status, strength and mobility. Evaluation of more targeted multi-disciplinary frailty interventions in this at risk group are required.
Thomas
Susie
S
Flinders University Department of Rehabilitation and Aged Care, Adelaide, Australia.
Miller
Michelle
M
Whitehead
Craig
C
Crotty
Maria
M
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000061:Accidents, Home / Q000706:statistics & numerical data; D000368:Aged; D001835:Body Weight; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D018737:Hand Strength; D006801:Humans; D008297:Male; D010865:Pilot Projects; D018570:Risk Assessment; D055948:Sarcopenia / Q000453:epidemiology; D013997:Time Factors