Journal ArticleDOI
Home visits by an occupational therapist for assessment and modification of environmental hazards: a randomized trial of falls prevention.
Robert G. Cumming,Margaret Thomas,George Szonyi,Glenn Salkeld,Elizabeth O'Neill,Christine Westbury,Gina Frampton,Gina Frampton +7 more
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TLDR
To determine whether occupational therapist home visits targeted at environmental hazards reduce the risk of falls, a large number of patients with a history of falls are referred to a therapist.Abstract:
OBJECTIVE: To determine whether occupational therapist home visits targeted at environmental hazards reduce the risk of falls
DESIGN: A randomized controlled trial
SETTING: Private dwellings in the community in Sydney, Australia
PARTICIPANTS: A total of 530 subjects (mean age 77 years), recruited primarily before discharge from selected hospital wards
INTERVENTION: A home visit by an experienced occupational therapist, who assessed the home for environmental hazards and facilitated any necessary home modifications
MEASUREMENTS: The primary study outcome was falls, ascertained over a 12-month follow-up period using a monthly falls calendar
RESULTS: Thirty six percent of subjects in the intervention group had at least one fall during follow-up, compared with 45% of controls (P = 050) The intervention was effective only among subjects (n = 206) who reported having had one or more falls during the year before recruitment into the study; in this group, the relative risk of at least one fall during follow-up was 064 (95% confidence interval, 050-083) Similar results were obtained when falls data were analyzed using survival analysis techniques (proportional and multiplicative hazards models) and fall rates (mean number of falls per person per year) About 50% of the recommended home modifications were in place at a 12-month follow-up visit
CONCLUSIONS: Home visits by occupational therapists can prevent falls among older people who are at increased risk of falling However, the effect may not be caused by home modifications alone Home visits by occupational therapists may also lead to changes in behavior that enable older people to live more safely in both the home and the external environment J Am Geriatr Soc 47:1397–1402, 1999read more
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Journal ArticleDOI
Interventions for preventing falls in older people living in the community
Lesley D Gillespie,Mary Clare Robertson,William J Gillespie,Catherine Sherrington,Simon Gates,Lindy Clemson,Sarah E Lamb +6 more
TL;DR: These interventions were more effective in people at higher risk of falling, including those with severe visual impairment, and home safety interventions appear to be more effective when delivered by an occupational therapist.
Journal ArticleDOI
Guideline for the Prevention of Falls in Older Persons
Reference EntryDOI
Interventions for preventing falls in older people living in the community (Review)
Lesley D Gillespie,M. Clare Robertson,William J. Gillespie,Sarah E Lamb,Simon Gates,Robert G. Cumming,Brian H. Rowe +6 more
TL;DR: Exercise interventions reduce risk and rate of falls, and home safety interventions did not reduce falls, but were effective in people with severe visual impairment, and in others at higher risk of falling.
Journal ArticleDOI
Development of a Common Outcome Data Set for Fall Injury Prevention Trials: The Prevention of Falls Network Europe Consensus
TL;DR: It is possible that fall‐prevention strategies have limited effect on falls that result in injuries or are ineffective in populations who are at a higher risk of injury.
Journal ArticleDOI
2010 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada: summary
Alexandra Papaioannou,Suzanne N Morin,Angela M. Cheung,Stephanie A. Atkinson,Jacques P. Brown,Sidney Feldman,David A. Hanley,Anthony B. Hodsman,Sophie A. Jamal,Stephanie M. Kaiser,Brent Kvern,Kerry Siminoski,William D. Leslie +12 more
TL;DR: There has been a paradigm shift in the prevention and treatment of osteoporosis and fractures, and the focus now is on preventing fragility fractures and their negative effects.
References
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Journal ArticleDOI
Risk factors for falls among elderly persons living in the community.
TL;DR: It is concluded that falls among older persons living in the community are common and that a simple clinical assessment can identify the elderly persons who are at the greatest risk of falling.
Journal ArticleDOI
Cox's Regression Model for Counting Processes: A Large Sample Study
TL;DR: In this article, the Cox regression model for censored survival data is extended to a model where covariate processes have a proportional effect on the intensity process of a multivariate counting process, allowing for complicated censoring patterns and time dependent covariates.
Journal ArticleDOI
A multifactorial intervention to reduce the risk of falling among elderly people living in the community.
Mary E. Tinetti,Dorothy I. Baker,Gail McAvay,Elizabeth B. Claus,Patricia Garrett,Margaret Gottschalk,Marie L. Koch,Kathryn Trainor,Ralph I. Horwitz +8 more
TL;DR: The multiple-risk-factor intervention strategy resulted in a significant reduction in the risk of falling among elderly persons in the community and among persons who had the targeted risk factors for falling, as compared with the control group.
Journal ArticleDOI
Risk factors for recurrent nonsyncopal falls. A prospective study.
TL;DR: Risk factors for having a single fall were few and relatively weak, but multiple falls were more predictable, and increased odds of two or more falls for persons who had difficulty standing up from a chair, difficulty performing a tandem walk, arthritis, Parkinson's disease, and a fall with injury during the previous year were found.
Journal ArticleDOI
Falls, Injuries Due to Falls, and the Risk of Admission to a Nursing Home
TL;DR: Among older people living in the community falls are a strong predictor of placement in a skilled-nursing facility; interventions that prevent falls and their sequelae may therefore delay or reduce the frequency of nursing home admissions.