Multifactorial assessment and targeted intervention to reduce falls among the oldest-old: a randomized controlled trial

Assumpta Ferrer,1 Francesc Formiga,2,3 Héctor Sanz,4 Oscar J de Vries,5 Teresa Badia,6 Ramón Pujol2,3 On behalf of the OCTABAIX Study Group 1Primary Healthcare Centre "El Plà" CAP-I, Sant Feliu de Llobregat, 2Geriatric Unit, Internal Medicine Servic...

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Autores principales:	Ferrer A, Formiga F, Sanz H, de Vries OJ, Badia T, Pujol R
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	elderly falls age 80 and older. Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/a5065ca0104246e48137ffa4a50bb8d8
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spelling	oai:doaj.org-article:a5065ca0104246e48137ffa4a50bb8d82021-12-02T00:33:35ZMultifactorial assessment and targeted intervention to reduce falls among the oldest-old: a randomized controlled trial1178-1998https://doaj.org/article/a5065ca0104246e48137ffa4a50bb8d82014-02-01T00:00:00Zhttps://www.dovepress.com/multifactorial-assessment-and-targeted-intervention-to-reduce-falls-am-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Assumpta Ferrer,1 Francesc Formiga,2,3 Héctor Sanz,4 Oscar J de Vries,5 Teresa Badia,6 Ramón Pujol2,3 On behalf of the OCTABAIX Study Group 1Primary Healthcare Centre "El Plà" CAP-I, Sant Feliu de Llobregat, 2Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, 3Bellvitge Biomedical Research Institute, IDIBELL, L'Hospitalet de Llobregat, 4Support Research Unit, Primary Health Department Costa Ponent, IDIAP Jordi Gol, Barcelona, Spain; 5Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands; 6Primary Healthcare Centre Martorell, Barcelona, Spain Background: The purpose of this study was to assess the effectiveness of a multifactorial intervention to reduce falls among the oldest-old people, including individuals with cognitive impairment or comorbidities. Methods: A randomized, single-blind, parallel-group clinical trial was conducted from January 2009 to December 2010 in seven primary health care centers in Baix Llobregat (Barcelona). Of 696 referred people who were born in 1924, 328 were randomized to an intervention group or a control group. The intervention model used an algorithm and was multifaceted for both patients and their primary care providers. Primary outcomes were risk of falling and time until falls. Data analyses were by intention-to-treat. Results: Sixty-five (39.6%) subjects in the intervention group and 48 (29.3%) in the control group fell during follow-up. The difference in the risk of falls was not significant (relative risk 1.28, 95% confidence interval [CI] 0.94–1.75). Cox regression models with time from randomization to the first fall were not significant. Cox models for recurrent falls showed that intervention had a negative effect (hazard ratio [HR] 1.46, 95% CI 1.03–2.09) and that functional impairment (HR 1.42, 95% CI 0.97–2.12), previous falls (HR 1.09, 95% CI 0.74–1.60), and cognitive impairment (HR 1.08, 95% CI 0.72–1.60) had no effect on the assessment. Conclusion: This multifactorial intervention among octogenarians, including individuals with cognitive impairment or comorbidities, did not result in a reduction in falls. A history of previous falls, disability, and cognitive impairment had no effect on the program among the community-dwelling subjects in this study. Keywords: elderly, falls, interventionFerrer AFormiga FSanz Hde Vries OJBadia TPujol RDove Medical Pressarticleelderlyfallsage 80 and older.GeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 9, Pp 383-394 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	elderly falls age 80 and older. Geriatrics RC952-954.6
spellingShingle	elderly falls age 80 and older. Geriatrics RC952-954.6 Ferrer A Formiga F Sanz H de Vries OJ Badia T Pujol R Multifactorial assessment and targeted intervention to reduce falls among the oldest-old: a randomized controlled trial
description	Assumpta Ferrer,1 Francesc Formiga,2,3 Héctor Sanz,4 Oscar J de Vries,5 Teresa Badia,6 Ramón Pujol2,3 On behalf of the OCTABAIX Study Group 1Primary Healthcare Centre "El Plà" CAP-I, Sant Feliu de Llobregat, 2Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, 3Bellvitge Biomedical Research Institute, IDIBELL, L'Hospitalet de Llobregat, 4Support Research Unit, Primary Health Department Costa Ponent, IDIAP Jordi Gol, Barcelona, Spain; 5Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands; 6Primary Healthcare Centre Martorell, Barcelona, Spain Background: The purpose of this study was to assess the effectiveness of a multifactorial intervention to reduce falls among the oldest-old people, including individuals with cognitive impairment or comorbidities. Methods: A randomized, single-blind, parallel-group clinical trial was conducted from January 2009 to December 2010 in seven primary health care centers in Baix Llobregat (Barcelona). Of 696 referred people who were born in 1924, 328 were randomized to an intervention group or a control group. The intervention model used an algorithm and was multifaceted for both patients and their primary care providers. Primary outcomes were risk of falling and time until falls. Data analyses were by intention-to-treat. Results: Sixty-five (39.6%) subjects in the intervention group and 48 (29.3%) in the control group fell during follow-up. The difference in the risk of falls was not significant (relative risk 1.28, 95% confidence interval [CI] 0.94–1.75). Cox regression models with time from randomization to the first fall were not significant. Cox models for recurrent falls showed that intervention had a negative effect (hazard ratio [HR] 1.46, 95% CI 1.03–2.09) and that functional impairment (HR 1.42, 95% CI 0.97–2.12), previous falls (HR 1.09, 95% CI 0.74–1.60), and cognitive impairment (HR 1.08, 95% CI 0.72–1.60) had no effect on the assessment. Conclusion: This multifactorial intervention among octogenarians, including individuals with cognitive impairment or comorbidities, did not result in a reduction in falls. A history of previous falls, disability, and cognitive impairment had no effect on the program among the community-dwelling subjects in this study. Keywords: elderly, falls, intervention
format	article
author	Ferrer A Formiga F Sanz H de Vries OJ Badia T Pujol R
author_facet	Ferrer A Formiga F Sanz H de Vries OJ Badia T Pujol R
author_sort	Ferrer A
title	Multifactorial assessment and targeted intervention to reduce falls among the oldest-old: a randomized controlled trial
title_short	Multifactorial assessment and targeted intervention to reduce falls among the oldest-old: a randomized controlled trial
title_full	Multifactorial assessment and targeted intervention to reduce falls among the oldest-old: a randomized controlled trial
title_fullStr	Multifactorial assessment and targeted intervention to reduce falls among the oldest-old: a randomized controlled trial
title_full_unstemmed	Multifactorial assessment and targeted intervention to reduce falls among the oldest-old: a randomized controlled trial
title_sort	multifactorial assessment and targeted intervention to reduce falls among the oldest-old: a randomized controlled trial
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/a5065ca0104246e48137ffa4a50bb8d8
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Multifactorial assessment and targeted intervention to reduce falls among the oldest-old: a randomized controlled trial

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