Patients with recurrent falls attending Accident & Emergency benefit from multifactorial intervention--a randomised controlled trial

Age Ageing. 2005 Mar;34(2):162-8. doi: 10.1093/ageing/afi053.


Objectives: To determine the effectiveness of multifactorial intervention to prevent falls in cognitively intact older persons with recurrent falls.

Design: Randomised controlled trial of multifactorial (medical, physiotherapy and occupational therapy) post-fall assessment and intervention compared with conventional care.

Setting: Accident & Emergency departments in a university teaching hospital and associated district general hospital.

Subjects: 313 cognitively intact men and women aged over 65 years presenting to Accident & Emergency with a fall or fall-related injury and at least one additional fall in the preceding year; 159 randomised to assessment and intervention and 154 to conventional care.

Outcome measures: primary outcome was the number of falls and fallers in 1 year after recruitment. Secondary outcomes included injury rates, fall-related hospital admissions, mortality and fear of falling.

Results: There were 36% fewer falls in the intervention group (relative risk 0.64, 95% confidence interval 0.46-0.90). The proportion of subjects continuing to fall (65% (94/144) compared with 68% (102/149) relative risk 0.95, 95% confidence interval 0.81-1.12), and the number of fall-related attendances and hospital admissions was not different between groups. Duration of hospital admission was reduced (mean difference admission duration 3.6 days, 95% confidence interval 0.1-7.6) and falls efficacy was better in the intervention group (mean difference in Activities Specific Balance Confidence Score of 7.5, 95% confidence interval 0.72-14.2).

Conclusion: Multifactorial intervention is effective at reducing the fall burden in cognitively intact older persons with recurrent falls attending Accident & Emergency, but does not reduce the proportion of subjects still falling.

Publication types

  • Case Reports
  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls / prevention & control*
  • Aged
  • Aged, 80 and over
  • Causality
  • Combined Modality Therapy
  • Emergency Service, Hospital*
  • Female
  • Follow-Up Studies
  • Hospitals, General
  • Hospitals, University
  • Humans
  • Male
  • Mental Status Schedule
  • Occupational Therapy*
  • Outcome Assessment, Health Care
  • Patient Care Team*
  • Patient Readmission / statistics & numerical data
  • Physical Therapy Modalities*
  • Risk Factors
  • Survival Rate
  • Wounds and Injuries / prevention & control
  • Wounds and Injuries / rehabilitation