Monika Siegrist1, Ellen Freiberger2, Christian Hentschke3, Martin Halle1,4, Barbara Geilhof1, Peter Landendoerfer5, Wolfgang Blank6, Cornel Christian Sieber3,7. 1. Department of Prevention and Sports Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany. 2. Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstr. 60, 90408, Nuremberg, Germany. Ellen.Freiberger@fau.de. 3. Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstr. 60, 90408, Nuremberg, Germany. 4. DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. 5. Institute of General Practice, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany. 6. Institute for General Practitioner, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany. 7. Department of Medicine, Kantonsspital Winterthur, Winterthur, Switzerland.
Abstract
BACKGROUND: Falls and fall-related injuries are common in community-dwelling older persons. Longitudinal data on effective fall prevention programs are rare. OBJECTIVE: Therefore, we evaluated a 4-months multi-component exercise fall prevention program in a primary care setting on long-term effects over 24 months on falls and concomitant injuries in older community-dwelling persons with high risk of falling. DESIGN AND SETTING: In the Prevention of Falls (PreFalls) study, forty general practitioners in Germany were cluster-randomized (1:1) into anintervention group (IG) or control group (CG). Three hundred seventy-eight independently living people with high risk of falling (78.1 ± 5.9 years, 75% women) were assigned to IG (n = 222) or CG (n = 156). INTERVENTION AND MEASUREMENTS: Patients in IG took part in a 4-months multi-component exercise program comprising strength and balance exercises (28 sessions); patients in CG received no intervention. Primary outcome measure was number of falls over 24 months, analyzed by a patient-level, linear mixed Poisson model. Secondary endpoints were number of fall-related injuries, changes in physical function, fear of falling, and mortality. RESULTS: After 24 months, the IG demonstrated significantly fewer falls (IRR = 0.63, p = 0.021), injurious falls (IRR = 0.69, p = 0.034), and less fear of falling (p = 0.005). The mortality rate was 5.0% in IG and 10.3% in CG (HR = 0.51, 95% CI: 0.24 to 1.12; p = 0.094). CONCLUSIONS: In older community-dwelling persons with high risk of falling, a short-term multi-component exercise intervention reduced falls and injurious falls, as well as fear of falling over 24 months.
RCT Entities:
BACKGROUND: Falls and fall-related injuries are common in community-dwelling older persons. Longitudinal data on effective fall prevention programs are rare. OBJECTIVE: Therefore, we evaluated a 4-months multi-component exercise fall prevention program in a primary care setting on long-term effects over 24 months on falls and concomitant injuries in older community-dwelling persons with high risk of falling. DESIGN AND SETTING: In the Prevention of Falls (PreFalls) study, forty general practitioners in Germany were cluster-randomized (1:1) into an intervention group (IG) or control group (CG). Three hundred seventy-eight independently living people with high risk of falling (78.1 ± 5.9 years, 75% women) were assigned to IG (n = 222) or CG (n = 156). INTERVENTION AND MEASUREMENTS: Patients in IG took part in a 4-months multi-component exercise program comprising strength and balance exercises (28 sessions); patients in CG received no intervention. Primary outcome measure was number of falls over 24 months, analyzed by a patient-level, linear mixed Poisson model. Secondary endpoints were number of fall-related injuries, changes in physical function, fear of falling, and mortality. RESULTS: After 24 months, the IG demonstrated significantly fewer falls (IRR = 0.63, p = 0.021), injurious falls (IRR = 0.69, p = 0.034), and less fear of falling (p = 0.005). The mortality rate was 5.0% in IG and 10.3% in CG (HR = 0.51, 95% CI: 0.24 to 1.12; p = 0.094). CONCLUSIONS: In older community-dwelling persons with high risk of falling, a short-term multi-component exercise intervention reduced falls and injurious falls, as well as fear of falling over 24 months.
Entities:
Keywords:
aged; exercise; falls; prevention; primary care
Authors: Klaus A Hauer; Gertrudis I J M Kempen; Michael Schwenk; Lucy Yardley; Nina Beyer; Chris Todd; Peter Oster; G A Rixt Zijlstra Journal: Gerontology Date: 2010-10-22 Impact factor: 5.140