03225nas a2200541   4500000000100000008004100001260001600042653001100058653001100069653000900080653000900089653001700098653002400115653002000139653001700159653001600176653002000192653002200212653003100234653001800265653002500283653002100308653001800329653004300347653001000390653002500400653001600425653003600441653002000477653003700497653002500534653002200559100001400581700001500595700001600610700001300626700001200639700001500651700001600666700001900682700001500701245015600716250001500872300001100887490000700898520172700905020005102632       2014                            d  c-738830850210aFemale10aHumans10aAged10aMale10aRisk Factors10aProspective Studies10aRisk Assessment10aTime Factors10aAge Factors10aNew South Wales10aAged, 80 and over10aActivities of Daily Living10aFrail Elderly10aGeriatric Assessment10aExercise Therapy10aMental health10aAccidental Falls/ prevention & control10aAging10aCooperative Behavior10aHouse Calls10aInterdisciplinary Communication10aMuscle Strength10aMuscle, Skeletal/physiopathology10aNutrition Assessment10aPatient Care Team1 aKurrle S.1 aLangron C.1 aLockwood K.1 aAggar C.1 aLord S.1 aCameron I.1 aMonaghan N.1 aSherrington C.1 aFairhall N00aEffect of a multifactorial, interdisciplinary intervention on risk factors for falls and fall rate in frail older people: a randomised controlled trial  a2014/01/02  a616-220 v433 a<p>
BACKGROUND: frail older people have a high risk of falling. OBJECTIVE: assess the effect of a frailty intervention on risk factors for falls and fall rates in frail older people. DESIGN: randomised controlled trial. PARTICIPANTS: 241 community-dwelling people aged 70+ without severe cognitive impairment who met the Cardiovascular Health Study frailty definition. INTERVENTION: multifactorial, interdisciplinary intervention targeting frailty characteristics with an individualised home exercise programme prescribed in 10 home visits from a physiotherapist and interdisciplinary management of medical, psychological and social problems. MEASUREMENTS: risk factors for falls were measured using the Physiological Profile Assessment (PPA) and mobility measures at 12 months by a blinded assessor. Falls were monitored with calendars. RESULTS: participants had a mean (SD) age of 83.3 (5.9) years, 68% were women and 216 (90%) completed the study. After 12 months the intervention group had significantly better performance than the control group, after controlling for baseline values, in the PPA components of quadriceps strength (between-group difference 1.84 kg, 95% CI 0.17-3.51, P = 0.03) and body sway (-90.63 mm, 95% CI -168.6 to -12.6, P = 0.02), short physical performance battery (1.58, 95% CI 1.02-2.14, P <!--= 0.001) and 4 m walk (0.06 m/s 95% CI 0.01-0.10, P = 0.02) with a trend toward a better total PPA score (-0.40, 95% CI -0.83-0.04, P = 0.07) but no difference in fall rates (incidence rate ratio 1.12, 95% CI 0.78-1.63, P = 0.53). CONCLUSION: the intervention improved performance on risk factors for falls but did not reduce the rate of falls. TRIAL REGISTRATION: ACTRN12608000250336.-->
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