Effect of a multifactorial, interdisciplinary intervention on risk factors for falls and fall rate in frail older people: a randomised controlled trial

Age Ageing. 2014 Sep;43(5):616-22. doi: 10.1093/ageing/aft204. Epub 2013 Dec 30.


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.

Keywords: exercise; falls; frail elderly; older people; randomised controlled trial.

Publication types

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

MeSH terms

  • Accidental Falls / prevention & control*
  • Activities of Daily Living
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging
  • Cooperative Behavior
  • Exercise Therapy*
  • Female
  • Frail Elderly*
  • Geriatric Assessment
  • House Calls*
  • Humans
  • Interdisciplinary Communication
  • Male
  • Mental Health
  • Muscle Strength
  • Muscle, Skeletal / physiopathology
  • New South Wales
  • Nutrition Assessment
  • Patient Care Team*
  • Prospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors

Associated data

  • ANZCTR/ACTRN12608000250336