- •Falls are a main cause of hospitalization, nursing home admission, and death in older subjects.
- •Falls clinics have shown effectiveness in improving mobility and balance, and in reducing falls rates in older patients.
- •Recurrent fallers and older fallers with functional disorders are at high risk of falls and injuries.
- •This study found fewer serious injuries in the 6 months following assessment in a fall clinic in high-risk older patients.
- •The level of adherence to the main recommendations and of satisfaction with the programme was >70%.
To evaluate whether a multifactorial programme delivered in a real practice setting would help prevent serious fall-related injuries in high-risk older patients.
A 6-month pre–post intervention study in 134 fallers (81.6 ± 7.2 years) consecutively referred to a fall prevention clinic after repeated falls in the previous year or after a fall associated with balance, gait, or strength disorders. The programme was delivered by a physiotherapist, an occupational therapist, a podiatrist, and a geriatrician based on a 3-hour fall risk assessment.
The proportion of patients with serious and moderate fall-related injuries was significantly lower in the 6 months after than in the 6-months preceding clinic attendance [8 (6.1%) vs 40 (30.5%), and 11 (8.2%) vs 19 (14.2%), respectively; p < 0.0001], as were the overall proportion of fallers (32.1% vs 95.4%; p < 0.0001) and the number of falls per patient (-5.2 ± -20.4; p < 0.0001). When compared with baseline, fear of falling at 6 months was reduced (p < 0.05), mobility was maintained, and the proportion of patients with an ADL score ≤ 2 was increased (5.6% vs 9.7% respectively; p < 0.001). Adherence to the main recommendations and satisfaction with the programme were > 75% at 6 months post-clinic.
A multifactorial fall prevention programme delivered by a multidisciplinary geriatric team in older patients at high risk of falling helps to reduce over a 6-month period the risk of serious and moderate injuries related to falls, the risk of falling, and the fear of falling, and helps to maintain mobility and improve functional status.
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Published online: January 25, 2019
Accepted: January 22, 2019
Received in revised form: January 13, 2019
Received: December 2, 2018
© 2019 Elsevier B.V. All rights reserved.