Unidad Docente de Medicina Familiar y Comunitaria de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía and University of Córdoba, Córdoba, Spain.
Arch Phys Med Rehabil. 2012 Oct;93(10):1677-84. doi: 10.1016/j.apmr.2012.03.035. Epub 2012 May 15.
To determine the effectiveness of a multifactorial intervention program to prevent falls among older adults as compared with a brief intervention.
Randomized controlled trial.
Eleven health centers located in Córdoba, Spain.
People over 70 years old (N=404), who are residents in the community.
The centers were randomized to either 1 of the 2 groups: intervention group (IG), of a multifactorial nature (individual advice, information leaflet, physical exercise workshop, and home visits), or control group (CG) (brief individual advice and information leaflet).
Fall rates and time until the fall; estimates of the relative and absolute risk of falls; and survival analysis and Cox regression.
Of the patients recruited, 133 were in the IG and 271 were in the CG. Around 33% in the IG and 30.25% in the CG had had a fall in the previous year (P=.56). After 12 months, the fall incidence rate was 17.29% in the IG and 23.61% in the CG (relative risk=0.73; 95% confidence interval [CI], 0.48-1.12; P=.146). Around 60% of the IG patients said they had increased the time spent on physical activity. In the IG, the incidence of falls at home was 27.5% compared with 49.3% in the CG (P=.04). Being a woman (odds ratio [OR]=1.62; 95% CI, 1.03-2.54), having a history of falls (OR=1.15; 95% CI, 1.05-1.26), suffering acute health problems (OR=2.19; 95% CI, 1.09-4.40), and doing moderate exercise (OR=1.91; 95% CI, 1.08-3.38) were found as factors associated with a higher risk of falls.
Although the reduction of falls in the IG was nearly halved, and after the intervention there was a significant reduction in the number of falls at these patients' homes, the multifactorial intervention program is no more effective than the brief intervention to reduce the overall risk of falls.
与简短干预相比，确定多因素干预方案预防老年人跌倒的有效性。
随机对照试验。
西班牙科尔多瓦的 11 个医疗中心。
年龄在 70 岁以上的社区居民（N=404）。
中心被随机分配到以下 2 组中的 1 组：干预组（IG），多因素性质（个人建议、信息传单、体育锻炼工作坊和家访），或对照组（CG）（简短的个人建议和信息传单）。
跌倒率和跌倒时间；跌倒风险的相对和绝对估计；生存分析和 Cox 回归。
在招募的患者中，IG 组有 133 例，CG 组有 271 例。IG 组和 CG 组各有 33%和 30.25%的患者在过去一年中跌倒过（P=.56）。12 个月后，IG 组的跌倒发生率为 17.29%，CG 组为 23.61%（相对风险=0.73；95%置信区间[CI]，0.48-1.12；P=.146）。大约 60%的 IG 患者表示他们增加了体育活动的时间。在 IG 组，家中跌倒的发生率为 27.5%，CG 组为 49.3%（P=.04）。女性（优势比[OR]=1.62；95%CI，1.03-2.54）、有跌倒史（OR=1.15；95%CI，1.05-1.26）、急性健康问题（OR=2.19；95%CI，1.09-4.40）和适度运动（OR=1.91；95%CI，1.08-3.38）被发现与更高的跌倒风险相关。
尽管 IG 组的跌倒减少了近一半，并且干预后这些患者家中的跌倒次数显著减少，但多因素干预方案并没有比简短干预更能降低总体跌倒风险。
