title: Effect of a multifactorial, interdisciplinary intervention on risk factors for falls and fall rate in frail older people: a randomised controlled trial.
abstract: BACKGROUND
  frail older people have a high risk of falling.
  
  
  OBJECTIVE
  assess the effect of a frailty intervention on risk factors for falls and fall rates in frail older people.
  
  
  METHODS
  randomised controlled trial.
  
  
  METHODS
  241 community-dwelling people aged 70+ without severe cognitive impairment who met the Cardiovascular Health Study frailty definition.
  
  
  METHODS
  multifactorial, interdisciplinary intervention targeting frailty characteristics with an individualised home exercise programme prescribed in 10 home visits from a physiotherapist and interdisciplinary management of medical, psychological and social problems.
  
  
  METHODS
  risk factors for falls were measured using the Physiological Profile Assessment (PPA) and mobility measures at 12 months by a blinded assessor. Falls were monitored with calendars.
  
  
  RESULTS
  participants had a mean (SD) age of 83.3 (5.9) years, 68% were women and 216 (90%) completed the study. After 12 months the intervention group had significantly better performance than the control group, after controlling for baseline values, in the PPA components of quadriceps strength (between-group difference 1.84 kg, 95% CI 0.17-3.51, P = 0.03) and body sway (-90.63 mm, 95% CI -168.6 to -12.6, P = 0.02), short physical performance battery (1.58, 95% CI 1.02-2.14, P ≤ 0.001) and 4 m walk (0.06 m/s 95% CI 0.01-0.10, P = 0.02) with a trend toward a better total PPA score (-0.40, 95% CI -0.83-0.04, P = 0.07) but no difference in fall rates (incidence rate ratio 1.12, 95% CI 0.78-1.63, P = 0.53).
  
  
  CONCLUSIONS
  the intervention improved performance on risk factors for falls but did not reduce the rate of falls.
  
  
  BACKGROUND
  ACTRN12608000250336.
authors.affiliation: Rehabilitation Studies Unit, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Nicola
authors.initials: N
authors.lastname: Fairhall
authors.affiliation: Musculoskeletal Division, The George Institute for Global Health, Sydney, New South Wales, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sherrington
authors.affiliation: Falls and Balance Research Group, Neuroscience Research Australia, Randwick, New South Wales, Australia.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
authors.affiliation: Division of Rehabilitation and Aged Care, Hornsby Ku-ring-gai Health Service, Sydney, New South Wales, Australia.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Kurrle
authors.affiliation: Division of Rehabilitation and Aged Care, Hornsby Ku-ring-gai Health Service, Sydney, New South Wales, Australia.
authors.forename: Colleen
authors.initials: C
authors.lastname: Langron
authors.affiliation: Rehabilitation Studies Unit, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia Division of Rehabilitation and Aged Care, Hornsby Ku-ring-gai Health Service, Sydney, New South Wales, Australia.
authors.forename: Keri
authors.initials: K
authors.lastname: Lockwood
authors.affiliation: Rehabilitation Studies Unit, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Noeline
authors.initials: N
authors.lastname: Monaghan
authors.affiliation: Faculty of Nursing and Midwifery, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Christina
authors.initials: C
authors.lastname: Aggar
authors.affiliation: Rehabilitation Studies Unit, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Ian D
authors.initials: ID
authors.lastname: Cameron
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003299:Cooperative Behavior; D005081:Exercise Therapy; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006792:House Calls; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008603:Mental Health; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology; D009517:New South Wales; D015596:Nutrition Assessment; D010348:Patient Care Team; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
keywords: exercise; falls; frail elderly; older people; randomised controlled trial