Article first published online: 20 FEB 2003
DOI: 10.1046/j.1532-5415.2003.51103.x
ABSTRACT
Keywords:
- accidental falls;
- older people;
- prevention;
- hip protector;
- exercise
OBJECTIVES: To evaluate the effectiveness of a multifaceted, nonpharmaceutical intervention on incidence of falls and fallers.
DESIGN: Prospective, cluster-randomized, controlled 12-month trial.
SETTING: Six community nursing homes in Germany.
PARTICIPANTS: Long-stay residents (n = 981) aged 60 and older; mean age 85; 79% female.
INTERVENTIONS:
Staff and resident education on fall prevention, advice on
environmental adaptations, progressive balance and resistance training,
and hip protectors.
MEASUREMENTS: Falls, fallers, and fractures.
RESULTS:
The incidence density rate of falls per 1,000 resident years (RY) was
2,558 for the control group (CG) and 1,399 for the intervention group
(IG) (relative risk (RR) = 0.55, 95% confidence interval (CI) =
0.41–0.73). Two hundred forty-seven (52.3%) fallers were detected in the
CG and 188 (36.9%) in the IG (RR = 0.75, 95% CI = 0.57–0.98). The
incidence density rate of frequent fallers (>2/year) was 115 (24.4%)
for the CG and 66 (13.0%) for the IG (RR = 0.56, 95% CI = 0.35–0.89).
The incidence density rate of hip fractures per 1,000 RY was 39 for the
CG and 43 for the IG (RR = 1.11, 95% CI = 0.49–2.51). Other fractures
were diagnosed with an incidence density rate of 52 per 1,000 RY for CG
and 41 per 1,000 RY for IG (RR = 0.78, 95% CI = 0.57–1.07).
CONCLUSION:
The incidence density rate of falls and fallers differed considerably
between the control and intervention groups. The study was underpowered
to demonstrate a significant difference of hip or nonhip fractures.
Because of a low fracture rate in both groups, the investigation of
fracture rates would have required a larger sample size to detect an
effect of the intervention.
Quelle: http://onlinelibrary.wiley.com/doi/10.1046/j.1532-5415.2003.51103.x/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=true
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