Older people can stay on their feet: final results of a community-based falls prevention programme

Objective: To evaluate a multi-strategic community-based intervention to prevent older people falling. Design: A prospective cohort study comparing randomly selected samples from intervention and control area target populations (residents ol er 60 years). Repent, cross-sectional (annual) reviews of fall-related hospitalizations were also conducted providing an independent measure of falls incidence in the target populations Setting: North Coast of New South Wales, Australia (a large, rural region). Subjects: Cohort study (1991-1995): randomly selected subjects aged 60 years and over, enrolled via telephone interview into intervention and control area cohorts. Cross-sectional study (1991/992-1994/1995): all residents aged 60 years and over, from intervention and control areas hospitalized with fall-related injuries Intervention: A I-year (1992-1995) multi-strategic intervention targeting fall-related knowledge, attitudes, behaviours and risk factors. Main outcome measures: Self-reported falls and fall-related hospitalization incidence rates. Fall-related knowledge, attitudes, behaviours and risk factor prevalence rates. Results: At follow-up there was a 22% non-significant lower incidence of self-reported falls in the intervention compared to the control cohort (p = 0.17). This was supported by a 20% lower fall-related hospitalization rate in target group residents from intervention compared to control areas (p < 0.01). Increased falls knowledge, physical activity and safe footwear were also observed in the intervention cohort together with improved balance and reduced intake of fall-related medications. Conclusions: Promotion of appropriate behaviours, environments and policies can improve fall-related outcomes given a commitment to involvement of older people and sufficient lead time.