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Prevention of falls in nursing homes : subgroup analyses of a randomized fall prevention trial
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Rapp, Kilian, Lamb, S. E. (Sallie E.), Buechele, Gisela, Lall, Ranjit, Lindemann, Ulrich and Becker, Clemens. (2008) Prevention of falls in nursing homes : subgroup analyses of a randomized fall prevention trial. Journal of the American Geriatrics Society, Vol.56 (No.6). pp. 1092-1097. ISSN 0002-8614
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Official URL: http://dx.doi.org/10.1111/j.1532-5415.2008.01739.x
Abstract
OBJECTIVES: To evaluate the effectiveness of a multifactorial fall prevention program in prespecified subgroups of nursing home residents. DESIGN: Secondary analysis of a cluster-randomized, controlled trial. SETTING: Six nursing homes in Germany. PARTICIPANTS: Seven hundred twenty-five long-stay residents; median age 86; 80% female. INTERVENTION: Staff and resident education on fall prevention, advice on environmental adaptations, recommendation to wear hip protectors, and progressive balance and resistance training. MEASUREMENTS: Time to first fall and the number of falls. Falls were assessed during the 12-month intervention period. Univariate regression analyses were performed, including a confirmatory test of interaction. RESULTS: The intervention was more effective in people with cognitive impairment (hazard ratio (HR)=0.49, 95% confidence interval (CI)=0.35-0.69) than in those who were cognitively intact (HR=0.91, 95% CI=0.68-1.22), in people with a prior history of falls (HR=0.47, 95% CI=0.33-0.67) than in those with no prior fall history (HR=0.77, 95% CI=0.58-1.01), in people with urinary incontinence (HR=0.59, 95% CI=0.45-0.77) than in those with no urinary incontinence (HR=0.98, 95% CI=0.68-1.42), and in people with no mood problems (incidence rate ratio (IRR)=0.41, 95% CI=0.27-0.61) than in those with mood problems (IRR=0.74, 95% CI=0.51-1.09). CONCLUSION: The effectiveness of a multifactorial fall prevention program differed between subgroups of nursing home residents. Cognitive impairment, a history of falls, urinary incontinence, and depressed mood were important in determining response.
| Item Type: | Journal Article |
|---|---|
| Subjects: | R Medicine > RA Public aspects of medicine |
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
| Library of Congress Subject Headings (LCSH): | Falls (Accidents) in old age -- Prevention, Nursing homes -- Safety measures, Nursing homes -- Safety regulations -- Germany |
| Journal or Publication Title: | Journal of the American Geriatrics Society |
| Publisher: | Blackwell Publishing |
| ISSN: | 0002-8614 |
| Date: | June 2008 |
| Volume: | Vol.56 |
| Number: | No.6 |
| Number of Pages: | 6 |
| Page Range: | pp. 1092-1097 |
| Identification Number: | 10.1111/j.1532-5415.2008.01739.x |
| Status: | Peer Reviewed |
| Publication Status: | Published |
| Access rights to Published version: | Restricted or Subscription Access |
| Funder: | Germany. Bundesministerium für Gesundheit [German Federal Ministry for Health] (BMG), Baden-Württemberg (Germany). Sozialministerium [State Ministry of Social Affairs] (BWS), Universität Ulm [University of Ulm] (Germany), Stadtverwaltung Ulm [Ulm City Council] (Germany), Bethesda Geriatrische Klinik [Bethesda Geriatric Clinic], Robert Bosch Stiftung [Robert Bosch Foundation] (Germany) |
| Grant number: | Va4-43164-1/403 (BMG), 44-5276-79 (BWS) |
| URI: | http://wrap.warwick.ac.uk/id/eprint/29902 |
Data sourced from Thomson Reuters' Web of Knowledge
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