title: Effectiveness of preventive home visits in reducing the risk of falls in old age: a randomized controlled trial.
abstract: BACKGROUND
  Falls in older people are a major public health issue, but the underlying causes are complex. We sought to evaluate the effectiveness of preventive home visits as a multifactorial, individualized strategy to reduce falls in community-dwelling older people.
  
  
  METHODS
  Data were derived from a prospective randomized controlled trial with follow-up examination after 18 months. Two hundred and thirty participants (≥80 years of age) with functional impairment were randomized to intervention and control groups. The intervention group received up to three preventive home visits including risk assessment, home counseling intervention, and a booster session. The control group received no preventive home visits. Structured interviews at baseline and follow-up provided information concerning falls in both study groups. Random-effects Poisson regression evaluated the effect of preventive home visits on the number of falls controlling for covariates.
  
  
  RESULTS
  Random-effects Poisson regression showed a significant increase in the number of falls between baseline and follow-up in the control group (incidence rate ratio 1.96) and a significant decrease in the intervention group (incidence rate ratio 0.63) controlling for age, sex, family status, level of care, and impairment in activities of daily living.
  
  
  CONCLUSIONS
  Our results indicate that a preventive home visiting program can be effective in reducing falls in community-dwelling older people.
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany. tobias.luck@medizin.uni-leipzig.de
authors.forename: Tobias
authors.initials: T
authors.lastname: Luck
authors.forename: Tom
authors.initials: T
authors.lastname: Motzek
authors.forename: Melanie
authors.initials: M
authors.lastname: Luppa
authors.forename: Herbert
authors.initials: H
authors.lastname: Matschinger
authors.forename: Steffen
authors.initials: S
authors.lastname: Fleischer
authors.forename: Yves
authors.initials: Y
authors.lastname: Sesselmann
authors.forename: Gudrun
authors.initials: G
authors.lastname: Roling
authors.forename: Katrin
authors.initials: K
authors.lastname: Beutner
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
authors.forename: Johann
authors.initials: J
authors.lastname: Behrens
authors.forename: Steffi G
authors.initials: SG
authors.lastname: Riedel-Heller
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000203:Activities of Daily Living; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003376:Counseling; D005260:Female; D015577:Geriatric Assessment; D006792:House Calls; D006801:Humans; D057187:Independent Living; D008297:Male; D016012:Poisson Distribution; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
keywords: evaluation; falls; home visits; prevention; randomized controlled trial