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Am J Public Health. 1994 November; 84(11): 1800–1806.
PMCID: PMC1615188

Preventing disability and falls in older adults: a population-based randomized trial.


OBJECTIVES. Because preventing disability and falls in older adults is a national priority, a randomized controlled trial was conducted to test a multicomponent intervention program. METHODS. From a random sample of health maintenance organization (HMO) enrollees 65 years and older, 1559 ambulatory seniors were randomized to one of three groups: a nurse assessment visit and follow-up interventions targeting risk factors for disability and falls (group 1, n = 635); a general health promotion nurse visit (group 2, n = 317); and usual care (group 3, n = 607). Data collection consisted of a baseline and two annual follow-up surveys. RESULTS. After 1 year, group 1 subjects reported a significantly lower incidence of declining functional status and a significantly lower incidence of falls than group 3 subjects. Group 2 subjects had intermediate levels of most outcomes. After 2 years of follow-up, the differences narrowed. CONCLUSIONS. The results suggest that a modest, one-time prevention program appeared to confer short-term health benefits on ambulatory HMO enrollees, although benefits diminished by the second year of follow-up. The mechanisms by which the intervention may have improved outcomes require further investigation.

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  • Schneider EL, Guralnik JM. The aging of America. Impact on health care costs. JAMA. 1990 May 2;263(17):2335–2340. [PubMed]
  • Fries JF. Aging, natural death, and the compression of morbidity. N Engl J Med. 1980 Jul 17;303(3):130–135. [PubMed]
  • Fries JF, Green LW, Levine S. Health promotion and the compression of morbidity. Lancet. 1989 Mar 4;1(8636):481–483. [PubMed]
  • Schneider EL, Brody JA. Aging, natural death, and the compression of morbidity: another view. N Engl J Med. 1983 Oct 6;309(14):854–856. [PubMed]
  • Buchner DM, Beresford SA, Larson EB, LaCroix AZ, Wagner EH. Effects of physical activity on health status in older adults. II. Intervention studies. Annu Rev Public Health. 1992;13:469–488. [PubMed]
  • Branch LG, Katz S, Kniepmann K, Papsidero JA. A prospective study of functional status among community elders. Am J Public Health. 1984 Mar;74(3):266–268. [PMC free article] [PubMed]
  • Wagner EH, LaCroix AZ, Buchner DM, Larson EB. Effects of physical activity on health status in older adults. I: Observational studies. Annu Rev Public Health. 1992;13:451–468. [PubMed]
  • Buchner DM, Wagner EH. Preventing frail health. Clin Geriatr Med. 1992 Feb;8(1):1–17. [PubMed]
  • LaCroix AZ, Guralnik JM, Berkman LF, Wallace RB, Satterfield S. Maintaining mobility in late life. II. Smoking, alcohol consumption, physical activity, and body mass index. Am J Epidemiol. 1993 Apr 15;137(8):858–869. [PubMed]
  • Benfante R, Reed D, Brody J. Biological and social predictors of health in an aging cohort. J Chronic Dis. 1985;38(5):385–395. [PubMed]
  • Pinsky JL, Leaverton PE, Stokes J., 3rd Predictors of good function: the Framingham Study. J Chronic Dis. 1987;40 (Suppl 1):159S–1822. [PubMed]
  • Guralnik JM, Kaplan GA. Predictors of healthy aging: prospective evidence from the Alameda County study. Am J Public Health. 1989 Jun;79(6):703–708. [PMC free article] [PubMed]
  • Sattin RW. Falls among older persons: a public health perspective. Annu Rev Public Health. 1992;13:489–508. [PubMed]
  • Grisso JA, Kelsey JL, Strom BL, Chiu GY, Maislin G, O'Brien LA, Hoffman S, Kaplan F. Risk factors for falls as a cause of hip fracture in women. The Northeast Hip Fracture Study Group. N Engl J Med. 1991 May 9;324(19):1326–1331. [PubMed]
  • Nevitt MC, Cummings SR, Kidd S, Black D. Risk factors for recurrent nonsyncopal falls. A prospective study. JAMA. 1989 May 12;261(18):2663–2668. [PubMed]
  • Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988 Dec 29;319(26):1701–1707. [PubMed]
  • Felson DT, Anderson JJ, Hannan MT, Milton RC, Wilson PW, Kiel DP. Impaired vision and hip fracture. The Framingham Study. J Am Geriatr Soc. 1989 Jun;37(6):495–500. [PubMed]
  • Tinetti ME, Williams TF, Mayewski R. Fall risk index for elderly patients based on number of chronic disabilities. Am J Med. 1986 Mar;80(3):429–434. [PubMed]
  • Mor V, Murphy J, Masterson-Allen S, Willey C, Razmpour A, Jackson ME, Greer D, Katz S. Risk of functional decline among well elders. J Clin Epidemiol. 1989;42(9):895–904. [PubMed]
  • Campbell AJ, Borrie MJ, Spears GF. Risk factors for falls in a community-based prospective study of people 70 years and older. J Gerontol. 1989 Jul;44(4):M112–M117. [PubMed]
  • Rowe JW, Kahn RL. Human aging: usual and successful. Science. 1987 Jul 10;237(4811):143–149. [PubMed]
  • Grimley Evans J. Prevention of age-associated loss of autonomy: epidemiological approaches. J Chronic Dis. 1984;37(5):353–363. [PubMed]
  • Wagner EH, Grothaus LC, Hecht JA, LaCroix AZ. Factors associated with participation in a senior health promotion program. Gerontologist. 1991 Oct;31(5):598–602. [PubMed]
  • Scholes D, LaCroix AZ, Wagner EH, Grothaus LC, Hecht JA. Tracking progress toward national health objectives in the elderly: what do restricted activity days signify? Am J Public Health. 1991 Apr;81(4):485–488. [PMC free article] [PubMed]
  • Wagner EH, LaCroix AZ, Grothaus LC, Hecht JA. Responsiveness of health status measures to change among older adults. J Am Geriatr Soc. 1993 Mar;41(3):241–248. [PubMed]
  • Cummings SR, Nevitt MC, Kidd S. Forgetting falls. The limited accuracy of recall of falls in the elderly. J Am Geriatr Soc. 1988 Jul;36(7):613–616. [PubMed]

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