Characteristics of patients who stop falling after a risk-based multidisciplinary intervention initiated in a geriatric day hospital.

BACKGROUND

Multidisciplinary interventions for fallers have provided conflicting results in part due to the diversity of fallers' profiles.

OBJECTIVES

to determine the characteristics of the subgroup of patients with a positive response to a multidisciplinary fall prevention program initiated in a geriatric day hospital.

DESIGN

Prospective observational study in day hospital.

METHODS

Patients > 75 years referred for falls during the last 3 months benefited from a multidisciplinary assessment to record their characteristics at baseline and to tailor a risk-based multidisciplinary intervention for fall prevention. Patients free from falls at the 3rd or 6th month were compared to persistent fallers for baseline characteristics.

RESULTS

Sixty-nine patients were assessed at baseline (mean age 85.2 y (SD=0.6)), 44 at the 3rd month and 21 at the 6th month. Baseline characteristics of the patients free from falls at the 3rd month were the lower number of previous non-serious falls (p=0.013), living in nursing home (p=0.045), a higher Berg balance score (p=0.02) and a better mental health-related quality of life (M HQol, p=0.045). On multivariate analysis restricted to home-dwelling patients, the positive predictive factors were less isolation at home (OR=0.028, 95%CI [0-0.813], p=0.037), a lower number of non-serious previous falls (OR= 0.526 [0.309- 0.894], p=0.018), a better M HQol (OR=1.205 [1.000-1.452], p=0.050) and a trend for younger age (OR= 0.662, [0.426-1.027], p=0.066).

CONCLUSION

Being able to call upon a support person (familial or institutional) to apply advice and a less serious risk of falling may be preliminary conditions for success in a multidisciplinary intervention initiated in a day hospital.