Hentschke Christian, Halle Martin, Geilhof Barbara, Landendoerfer Peter, Blank Wolfgang, Sieber Cornel Christian, Siegrist Monika, Freiberger Ellen
Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstr. 60, 90408, Nuremberg, Germany.
Department of Prevention and Sports Medicine, University Hospital 'rechts der Isar', Technical University of Munich, Munich, Germany.
J Gen Intern Med. 2021 Jul 8. doi: 10.1007/s11606-021-06944-w.
Falls and fall-related injuries are common in community-dwelling older persons. Longitudinal data on effective fall prevention programs are rare.
Therefore, we evaluated a 4-months multi-component exercise fall prevention program in a primary care setting on long-term effects over 24 months on falls and concomitant injuries in older community-dwelling persons with high risk of falling.
In the Prevention of Falls (PreFalls) study, forty general practitioners in Germany were cluster-randomized (1:1) into an intervention group (IG) or control group (CG). Three hundred seventy-eight independently living people with high risk of falling (78.1 ± 5.9 years, 75% women) were assigned to IG (n = 222) or CG (n = 156).
Patients in IG took part in a 4-months multi-component exercise program comprising strength and balance exercises (28 sessions); patients in CG received no intervention. Primary outcome measure was number of falls over 24 months, analyzed by a patient-level, linear mixed Poisson model. Secondary endpoints were number of fall-related injuries, changes in physical function, fear of falling, and mortality.
After 24 months, the IG demonstrated significantly fewer falls (IRR = 0.63, p = 0.021), injurious falls (IRR = 0.69, p = 0.034), and less fear of falling (p = 0.005). The mortality rate was 5.0% in IG and 10.3% in CG (HR = 0.51, 95% CI: 0.24 to 1.12; p = 0.094).
In older community-dwelling persons with high risk of falling, a short-term multi-component exercise intervention reduced falls and injurious falls, as well as fear of falling over 24 months.
跌倒及与跌倒相关的损伤在社区居住的老年人中很常见。关于有效预防跌倒项目的纵向数据很少。
因此，我们在初级保健机构中评估了一项为期4个月的多成分运动预防跌倒项目，该项目对社区居住的高跌倒风险老年人在24个月内对跌倒及伴随损伤的长期影响。
在预防跌倒（PreFalls）研究中，德国的40名全科医生被整群随机（1:1）分为干预组（IG）或对照组（CG）。378名独立生活的高跌倒风险人群（78.1±5.9岁，75%为女性）被分配到IG组（n = 222）或CG组（n = 156）。
IG组的患者参加了一个为期4个月的多成分运动项目，包括力量和平衡练习（28节课程）；CG组的患者未接受干预。主要结局指标是24个月内的跌倒次数，通过患者水平的线性混合泊松模型进行分析。次要终点是与跌倒相关的损伤次数、身体功能变化、跌倒恐惧和死亡率。
24个月后，IG组的跌倒次数（发病率比[IRR]=0.63，p = 0.021）、致伤性跌倒次数（IRR = 0.69，p = 0.034）显著减少，跌倒恐惧也减轻（p = 0.005）。IG组的死亡率为5.0%，CG组为10.3%（风险比[HR]=0.51，95%置信区间[CI]：0.24至1.12；p = 0.094）。
在社区居住的高跌倒风险老年人中，短期多成分运动干预在24个月内减少了跌倒、致伤性跌倒以及跌倒恐惧。
