Please select the eligibility criteria that correspond to the clinical trial below.
Title: Multifactorial, Evidence-based Program of Screening, Risk Modification and Physical Therapy to Prevent Falls Among Vulnerable Elderly Recently Discharged From Hospital to the Community.
Brief Summary: Background: Falls are the leading cause of injury among older adults in Singapore, but falls among the elderly can be preventable and the risks are predictable. Translating this understanding of falls etiology into an integrated clinical and public health program that is accessible to the elderly is a critical health services delivery challenge.

Hypothesis: An evidence-based program of screening, risk modification and physical therapy delivered in a community setting will reduce recurrent falls incidence among a high-risk group of elderly recently discharged to the community.

Methodology: This randomized controlled trial targets patients seen at Emergency Department (ED) for a fall or fall-related injuries who are at least 65 years old and will be discharged to home. Upon signing the informed consent form, the participants will be followed up for nine months from the baseline assessment during which the participants are randomized into either a control or the intervention group. The participants in the intervention group will be provided with a multifactorial program of screening, risk modification and physical therapy focused on progressive strength, balance, and gait training either as an individualized program or a group setting in the community for the first three months from the date of randomization. The number of recurrent falls will be monitored via a falls prevention diary maintained by (or for) each participant.


Options:
A: Inclusion Criteria:

* Age ≥ 65 years
* Seen in the Emergency Department for a fall or injury related to a fall
* Able to follow 3 step commands
* Singapore citizen or Permanent Resident
* Living at home upon discharge
* Provision of informed consent
* If admitted to the hospital, the illness or disability is one from which they are expected to recover basic ADLs or weight bearing of the lower extremity within the next month

Exclusion Criteria:

* Those patients with severe physical and/or mental impairments which preclude participation in a program of physical therapy (as determined by a primary physician) will NOT be eligible for participation.
* Unable to participate in the exercise program due to conflicting schedules (e.g. full-time employment, on dialysis)
* Serious life limiting illness
* Patients seen at ED due to road traffic accidents
* Unable to walk even with assistance
* Not community dwelling prior to ED visit
* Total blindness
* Needs emergency inpatient surgery and, if admitted to the hospital, the illness or disability is one from which they are not expected to recover basic ADLs or weight bearing in the lower extremity within the next one month.
B: Inclusion Criteria:

* 65 years of age or older
* home-dweller
* having fallen at least once during the previous 12 months
* at least moderate cognitive abilities (MMSE over 17)
* able to walk 10 metres independently

Exclusion Criteria:

* MMSE under 17
C: Inclusion Criteria:

* Patients aged 65 years and over
* Patients with a high risk profile (at least one fall event in the last 12 months, Berg scale score ≤ 45 and at least one fall event during in-hospital stay) of recurrent falling
* Patients discharged from the Institute of Fondazione Salvatore Maugeri, IRCCS after a period of rehabilitation and living independently

Exclusion Criteria:

* Patients' inability to sign the informed consent
* Patients living in a nursing home
* Patients permanently bedridden or fully dependent on a wheelchair
* Patients with cancer
* Patients with Mini Mental Examination State (MMSE) \< 18
* Patients with MMSE \< 24 lacking of caregiver at home
* Patients with neurological impairment (i.e. aphasia and neglect)
D: Inclusion Criteria:

* Community-dwelling older adults, men and women aged 60 and over who have fallen at least once in the last 12 months

Exclusion Criteria:

* A previous diagnosis of dementia or a cognitive decline;
* A previous stroke with a severe neurological impairment;
* A progressive neurological disease;
* A severe visual deficiency;
* Any acute illness that the physician considers as an exercise contra-indication;
* An acute vertigo or dizziness less than 3 months duration;
* Inability to keep on standing, even with the use of a walking aid or other device;
* Unable to communicate;
* Those who are engaged in a regular exercise program, including physical therapy, with a frequency of equal to or more than twice a week such as: muscle strengthening, balance or gait exercise, Tai Chi and Yoga

Answer: A