Prevention of falls and near-falls in community-dwelling elder people: a randomised trial

In the causative mechanism of falls among older people, slips and trips are significant precursors. This two-year trial assessed the effectiveness of multi-component interventions in reducing the incidence of slips, trips and falls among the well, older community. Two hundred and fifty-two members of the National Seniors Organisation in Brisbane were divided into four groups which were randomly allocated to interventions. The prevention strategies included education and awareness raising, exercise sessions, home safety advice, and clinical assessment. The interventions combined the strategies in an add-on approach. The outcome of interest was the occurrence of a slip, trip or fall, monitored prospectively using a daily calendar diary. Using Cox's proportional hazards regression model, adjusted Hazard Ratios comparing intervention groups with the control ranged from 0.35 (0.17-0.73) to 0.48 (0.25-0.91) for slips; 0.29 (0.16-0.51) to 0.45 (0.27-0.74) for trips; and 0.60 (0.36-1.01) to 0.82 (0.51-1.31) for falls. Falls incidence rates measured at follow-up demonstrated sustainability of the program. This study makes an important contribution to the priority health issue of falls prevention by showing that effective. sustainable, low-cost programs can be introduced through community-based organisations to reduce the incidence of slips, trips and falls in well, older people