- 期刊
多面向介入對不同跌倒風險老年人之跌倒預防成效
Effects of Multifaceted Fall Prevention Program on Community-dwelling Elderly with Different Fall Risks
摘要
Background: Falls are the leading cause of morbidity and mortality among people aged 65 years and older, resulting in marked costs and social burden. The purpose of this study was to evaluate the effect of multifaceted fall prevention program on community-dwelling elderly of different fall risks. Methods: Community-dwelling elderly aged 65 and older who met our fall screening criteria were recruited to participate in a stratified randomized controlled fall-prevention trial. Multifaceted intervention included exercise program, fall prevention education courses, recommendations for home hazards modification, as well as referrals for medication or vision check-up. The control group got recommendation and referrals without direct exercise intervention. Primary outcome was incidence of falls in 12 months. Secondary outcomes were PPA battery (including vision, muscular strength, reaction time, balance and proprioception), timed up-and-go (TUG), Taiwan version of International Physical Activity Questionnaire (IPAQ), EuroQoL-5D, and Fall Efficacy Scale (FES). Results: This study recruited 411 older participants with mean age of 77±7 years from hospital outpatient clinics or communities. The fall incidence within I-year for IG (29%) and CG (29%) showed no significant difference. Subgroup analyses stratified by PPA risk-level found that there was no significant difference in fall incidences of both groups among any stratum of fall-risk: low risk (IG: CG= 19%: 27%, p= .358), moderate risk (IG: CG=40%; 24%, p=.078), and marked risk (IG: CG=28%: 35%, p=.327). The fall incidence during the I-year follow-up period significantly decreased from 48.1 % to 28.6%, (p＜.001) in IG, while no significant decrease in CG (36.3%→28.9%, p=.101). Both IG and CG improved significantly in most secondary outcomes after intervention, especially for those with moderate or marked fall risk; however, it revealed no significant within-group difference. Conclusion: The findings of 29% fall incidence in both groups during the I-year follow-up period along with the significant decrease of fall incidence from 48.1% to 28.6% in IG might suggest the potential role of the multifaceted fall-prevention program. Interventions including recommendation and referrals seemed to take some effects on improving physical functions of the elderly, especially to the moderate or marked risk group. Whether higher-intensity of longer duration exercise program is required to significantly decrease the fall incidence warrants further study.
並列摘要
Background: Falls are the leading cause of morbidity and mortality among people aged 65 years and older, resulting in marked costs and social burden. The purpose of this study was to evaluate the effect of multifaceted fall prevention program on community-dwelling elderly of different fall risks. Methods: Community-dwelling elderly aged 65 and older who met our fall screening criteria were recruited to participate in a stratified randomized controlled fall-prevention trial. Multifaceted intervention included exercise program, fall prevention education courses, recommendations for home hazards modification, as well as referrals for medication or vision check-up. The control group got recommendation and referrals without direct exercise intervention. Primary outcome was incidence of falls in 12 months. Secondary outcomes were PPA battery (including vision, muscular strength, reaction time, balance and proprioception), timed up-and-go (TUG), Taiwan version of International Physical Activity Questionnaire (IPAQ), EuroQoL-5D, and Fall Efficacy Scale (FES). Results: This study recruited 411 older participants with mean age of 77±7 years from hospital outpatient clinics or communities. The fall incidence within I-year for IG (29%) and CG (29%) showed no significant difference. Subgroup analyses stratified by PPA risk-level found that there was no significant difference in fall incidences of both groups among any stratum of fall-risk: low risk (IG: CG= 19%: 27%, p= .358), moderate risk (IG: CG=40%; 24%, p=.078), and marked risk (IG: CG=28%: 35%, p=.327). The fall incidence during the I-year follow-up period significantly decreased from 48.1 % to 28.6%, (p＜.001) in IG, while no significant decrease in CG (36.3%→28.9%, p=.101). Both IG and CG improved significantly in most secondary outcomes after intervention, especially for those with moderate or marked fall risk; however, it revealed no significant within-group difference. Conclusion: The findings of 29% fall incidence in both groups during the I-year follow-up period along with the significant decrease of fall incidence from 48.1% to 28.6% in IG might suggest the potential role of the multifaceted fall-prevention program. Interventions including recommendation and referrals seemed to take some effects on improving physical functions of the elderly, especially to the moderate or marked risk group. Whether higher-intensity of longer duration exercise program is required to significantly decrease the fall incidence warrants further study.