BACKGROUND: falls are common in older people, but evidence for the effectiveness of preventative home adaptations is limited. AIM: determine whether a national home adaptation service, Care&Repair Cymru (C&RC), identified individuals at risk of falls occurring at home and reduced the likelihood of falls. STUDY DESIGN: retrospective longitudinal controlled non-randomised intervention cohort study. SETTING: our cohort consisted of 657,536 individuals aged 60+ living in Wales (UK) between 1 January 2010 and 31 December 2017. About 123,729 individuals received a home adaptation service. METHODS: we created a dataset with up to 41 quarterly observations per person. For each quarter, we observed if a fall occurred at home that resulted in either an emergency department or an emergency hospital admission. We analysed the data using multilevel logistic regression. RESULTS: compared to the control group, C&RC clients had higher odds of falling, with an odds ratio (OR [95% confidence interval]) of 1.93 [1.87, 2.00]. Falls odds was higher for females (1.44 [1.42, 1.46]), older age (1.07 [1.07, 1.07]), increased frailty (mild 1.57 [1.55, 1.60], moderate 2.31 [2.26, 2.35], severe 3.05 [2.96, 3.13]), and deprivation (most deprived compared to least: 1.16 [1.13, 1.19]). Client fall odds decreased post-intervention; OR 0.97 [0.96, 0.97] per quarter. Regional variation existed for falls (5.8%), with most variation at the individual level (31.3%). CONCLUSIONS: C&RC identified people more likely to have an emergency fall admission occurring at home, and their service reduced the odds of falling post-intervention. Service provisioning should meet the needs of an individual and need varies by personal and regional circumstance.
BACKGROUND: falls are common in older people, but evidence for the effectiveness of preventative home adaptations is limited. AIM: determine whether a national home adaptation service, Care&Repair Cymru (C&RC), identified individuals at risk of falls occurring at home and reduced the likelihood of falls. STUDY DESIGN: retrospective longitudinal controlled non-randomised intervention cohort study. SETTING: our cohort consisted of 657,536 individuals aged 60+ living in Wales (UK) between 1 January 2010 and 31 December 2017. About 123,729 individuals received a home adaptation service. METHODS: we created a dataset with up to 41 quarterly observations per person. For each quarter, we observed if a fall occurred at home that resulted in either an emergency department or an emergency hospital admission. We analysed the data using multilevel logistic regression. RESULTS: compared to the control group, C&RC clients had higher odds of falling, with an odds ratio (OR [95% confidence interval]) of 1.93 [1.87, 2.00]. Falls odds was higher for females (1.44 [1.42, 1.46]), older age (1.07 [1.07, 1.07]), increased frailty (mild 1.57 [1.55, 1.60], moderate 2.31 [2.26, 2.35], severe 3.05 [2.96, 3.13]), and deprivation (most deprived compared to least: 1.16 [1.13, 1.19]). Client fall odds decreased post-intervention; OR 0.97 [0.96, 0.97] per quarter. Regional variation existed for falls (5.8%), with most variation at the individual level (31.3%). CONCLUSIONS: C&RC identified people more likely to have an emergency fall admission occurring at home, and their service reduced the odds of falling post-intervention. Service provisioning should meet the needs of an individual and need varies by personal and regional circumstance.
Authors: Sarah E Rodgers; Ronan A Lyons; Rohan Dsilva; Kerina H Jones; Caroline J Brooks; David V Ford; Gareth John; Jean-Philippe Verplancke Journal: J Public Health (Oxf) Date: 2009-05-15 Impact factor: 2.341
Authors: Kim Delbaere; Jacqueline C T Close; Jörg Heim; Perminder S Sachdev; Henry Brodaty; Melissa J Slavin; Nicole A Kochan; Stephen R Lord Journal: J Am Geriatr Soc Date: 2010-09 Impact factor: 5.562
Authors: Maria Guzman-Castillo; Sara Ahmadi-Abhari; Piotr Bandosz; Simon Capewell; Andrew Steptoe; Archana Singh-Manoux; Mika Kivimaki; Martin J Shipley; Eric J Brunner; Martin O'Flaherty Journal: Lancet Public Health Date: 2017-05-23
Authors: Kerina H Jones; David V Ford; Chris Jones; Rohan Dsilva; Simon Thompson; Caroline J Brooks; Martin L Heaven; Daniel S Thayer; Cynthia L McNerney; Ronan A Lyons Journal: J Biomed Inform Date: 2014-01-15 Impact factor: 6.317
Authors: Andrew Clegg; Chris Bates; John Young; Ronan Ryan; Linda Nichols; Elizabeth Ann Teale; Mohammed A Mohammed; John Parry; Tom Marshall Journal: Age Ageing Date: 2016-03-03 Impact factor: 10.668