[Randomized clinical trial of a fall-prevention strategy for institutionalized elderly based on the Mini Falls Assessment Instrument]

Abstract

Introduction: The Mini Falls Assessment Instrument (MFAI) identifies risk factors for falls in an individual and links them to specific interventions. This study evaluates the effectiveness of MFAI as the basis for a falls prevention strategy in institutionalized elderly.

Material and methods: A cluster randomized clinical trial (identifier NCT00888953) was conducted in 16 nursing homes randomized to apply MFAI (intervention) or a modified version not linked to actions (control). The primary endpoint was the occurrence of falls during follow-up (12 months). Secondary variables were total number of falls, physical function, quality of life, functional status, and adverse effects.

Results: Data from 330 participants (197 intervention, 137 control) were analyzed. Both groups had a similar number of risk factors: 7 in the intervention group (range 1-12) and 8 (1-13) in the control group. In the intervention group there were more fallers (49% vs. 38%), and higher number of falls (315 vs. 109), and fall rate per 100 person-years (192.5 vs. 179.8) than the control group. In the multivariate analysis, there were no significant differences in fall risk (odds ratio=1.45; 95% confidence interval [CI]: .67 to 3.14; P=.350), but the incidence rate is significantly higher in the intervention group (Incidence rate ratio=2.23; 95% CI: 1.43 to 3.48; P<.001).

Conclusions: The results on the efficacy of the MFAI as a fall prevention strategy are inconclusive. Additional studies are needed in order to provide good quality evidence.

Keywords: Accidental falls; Caídas accidentales; Ensayo clínico aleatorizado; Medición de riesgo; Nursing homes; Randomized controlled trial; Residencias; Risk assessment.