105A RANDOMISED CONTROLLED STUDY ON INDIVIDUALLY-TAILORED MULTIFACTORIAL FALLS INTERVENTION IN OLDER FALLERS IN MALAYSIA

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Abstract

Introduction: Falls is a major geriatric health problem worldwide. However, most falls studies were focused in Western, developed countries. This randomized-controlled study evaluates the benefits of multifactorial intervention among older fallers of a lower-middle income nation. Our objective is to evaluate whether individually-tailored multifactorial interventions will reduce falls in our older population.

Methods: Three hundred older individuals aged ≥ 65 years with a history of ≥2 falls, or one injurious fall in the past 12 months will be recruited from accident and emergency, primary care department and geriatric outpatients. Participants are randomized to conventional care and life-style advice (control group) or individually-tailored multifactorial interventions (intervention group). Interventions include the Otago exercise programme, home hazard modifications, visual correction, review of culprit medications and cardiovascular interventions. Primary outcome measures are falls recurrence recorded with monthly falls diaries and telephone interviews. Secondary outcome measures include number of falls, balance-related physical capabilities, quality of life (CASP-19), psychological well-being (DASS-21) and falls efficacy (short FES-I).

Results: Recruitment commenced in July 2012. To date, 112 fallers have been assessed with 47 excluded for unmet criteria. The mean (standard deviation) age of participants was 73.6 (6.8) years, where 75 (67%) were female. 18/112 (16%) reported symptoms of vertigo, 20 (18%) presyncope, 44 (39%) dizziness and 13 (12%) loss of consciousness. A total of 397 falls were reported by the 112 fallers, 338/397 (86%) falls occurred indoors. 69/112 (61%) had a gait and balance disorder, 26/112 (23%) had visual impairment and 34/112 (30%) had possible home hazards. 32/76 (42%) had unexplained falls.

Conclusion: Previous studies evaluating treatment for falls have reported variable outcomes. It is therefore vital to test the efficacy of multifactorial interventions in our population. Potential findings will be invaluable in advancing falls prevention methods, reducing healthcare burdens and improving the quality-of-life of our older community.

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