Effectiveness of a Multifaceted Intervention on Falls in Nursing Home Residents

Authors: Becker C.¹; Kron M.²; Lindemann U.¹; Sturm E.¹; Eichner B.¹; Walter-Jung B.¹; Nikolaus T.¹

Source: Journal of the American Geriatrics Society, Volume 51, Number 3, March 2003 , pp. 306-313(8)

Publisher: Wiley-Blackwell

Abstract:

J Am Geriatr Soc 51:306–313, 2003. 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.

Keywords: accidental falls; older people; prevention; hip protector; exercise

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1532-5415.2003.51103.x

Affiliations: 1: Bethesda Geriatric Clinic, Academic Center at the University of Ulm, Ulm, Germany; and 2: Department of Biometry and Medical Documentation, Universität Ulm, Ulm, Germany.

Publication date: 2003-03-01

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