Preventing disability and falls in older adults: a population-based randomized trial

Am J Public Health. 1994 Nov;84(11):1800-6. doi: 10.2105/ajph.84.11.1800.


Objectives: Because preventing disability and falls in older adults is a national priority, a randomized controlled trial was conducted to test a multicomponent intervention program.

Methods: From a random sample of health maintenance organization (HMO) enrollees 65 years and older, 1559 ambulatory seniors were randomized to one of three groups: a nurse assessment visit and follow-up interventions targeting risk factors for disability and falls (group 1, n = 635); a general health promotion nurse visit (group 2, n = 317); and usual care (group 3, n = 607). Data collection consisted of a baseline and two annual follow-up surveys.

Results: After 1 year, group 1 subjects reported a significantly lower incidence of declining functional status and a significantly lower incidence of falls than group 3 subjects. Group 2 subjects had intermediate levels of most outcomes. After 2 years of follow-up, the differences narrowed.

Conclusions: The results suggest that a modest, one-time prevention program appeared to confer short-term health benefits on ambulatory HMO enrollees, although benefits diminished by the second year of follow-up. The mechanisms by which the intervention may have improved outcomes require further investigation.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Accidental Falls / prevention & control*
  • Accidental Falls / statistics & numerical data
  • Activities of Daily Living
  • Age Factors
  • Aged
  • Disabled Persons / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Geriatric Assessment
  • Health Maintenance Organizations
  • Health Promotion / organization & administration*
  • Humans
  • Incidence
  • Male
  • Nursing Assessment / organization & administration*
  • Program Evaluation
  • Risk Factors