Highlights
- •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%.
Abstract
Objective
To evaluate whether a multifactorial programme delivered in a real practice setting
would help prevent serious fall-related injuries in high-risk older patients.
Design
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.
Results
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.
Conclusions
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.
Keywords
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Article info
Publication history
Published online: January 25, 2019
Accepted:
January 22,
2019
Received in revised form:
January 13,
2019
Received:
December 2,
2018
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
