Nursing Homes Study of Fall Risk Assessment Oriented to Intervention

Study Overview
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Brief Summary
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The aim of the study is to establish the impact of a falls screening questionnaire in the adoption of preventive interventions and eventually in the reduction of falls and its consequences in elder people living in nursing homes.

Detailed Description
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Falls are the most frequent accidents in nursing homes, affecting more than a third of residents each year. Up to 10% of fallers require hospitalization or suffer a fracture. Psychological consequences affects between 20 and 80% of fallers, which suffer a lack of self-confidence that leads to reduction of activities and an increase of the dependence in activities of daily living. Not all the residents have the same risk, and each person can have more than one risk factor that can be identified (previous falls, self confidence, weakness, gait disorders, dizziness, cognitive impairment, etc). Identification of risk factors is the first step to reduce falls, but is not enough by itself. For this reason, interventions directed towards the correction of identified risk factors are required. In this setting, multifactorial interventions are the most successful to reduce falls numbers and its consequences. As individual randomization of residents presents important inconveniences (group contamination, control arm residents could felt discriminated), we will randomized nursing homes to each group.

Official Title
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Estudio de Medida Del Riesgo de Caídas Orientada a la Intervención en Residencias

Conditions
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Accidental Falls, Activities of Daily Living, Quality of Life, Self-Efficacy

Intervention / Treatment
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* Other: Fall risk assessment
* Other: Tailored intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: People with or without cognitive impairment living indefinitely in a nursing home place Able to walk with or without any kind of help or able to self transfer (as defined in category d420 of the WHO International Classification of Functioning, Disability and Health) without help Give their consent (or the legal guardian in case of cognitive impairment). Exclusion Criteria: Terminal illness (expected death before 6 months). Occupying temporarily a nursing home place (convalescence period) or another kind of place(day center, long term care, etc).

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Residents living in nursing homes allocated to intervention group. Assessment of risk factors. Implementation of a multifactorial tailored program to prevent falls. | Other: Fall risk assessment<br>* Assessment of presence of risk factors (previous falls, self efficacy, balance and gait disorders, weakness, daily living impairment, limb pain, foot problems, dizziness, cognitive impairment, vision impairment, depression, urinary incontinence, heart disease, polimedication and consumption of neuroleptics and psychotropic medication)<br>* Other names: Mini Falls Assessment (MFA);Other: Tailored intervention<br>* Induction of an intervention for each identified risk factor. If is possible the intervention will be directed towards the treatment of the underlying cause.<br>|
| Other: Control<br>Residents living in nursing homes allocated to control group. Assessment of risk factors. Receive the usual attention. | Other: Fall risk assessment<br>* Assessment of presence of risk factors (previous falls, self efficacy, balance and gait disorders, weakness, daily living impairment, limb pain, foot problems, dizziness, cognitive impairment, vision impairment, depression, urinary incontinence, heart disease, polimedication and consumption of neuroleptics and psychotropic medication)<br>* Other names: Mini Falls Assessment (MFA);|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of fallers | People who at least have one fall during the follow-up period. Fall:unexpected event in which the participants come to rest on the ground, floor, or lower level | one year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of falls | Number of falls per person/time. | one year | 
| Number of people who has a fracture as a consequence of a fall |  | one year | 
| Quality of life (only in residents without cognitive impairment). |  | One year | 
| Activities of daily living |  | One year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Falls, Nursing Homes, Elderly, Prevention, Spain, Cluster Randomized Clinical Trial