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The population approach to falls injury prevention in older people: findings of a two community trial.

McClure RJ, Hughes K, Ren C, McKenzie K, Dietrich U, Vardon P, Davis E, Newman B - BMC Public Health (2010)

Bottom Line: The aim of the study was to quantify the effectiveness of a streamlined (and thus potentially sustainable and cost-effective), population-based, multi-factorial falls injury prevention program for people over 60 years of age.The interventions in neither community substantially decreased the rate of falls-related injury among people aged 60 years or older, although there was some evidence of reductions in occurrence of multiple falls reported by women.In addition, there was some indication of improvements in fall-related risk factors, but the magnitudes were generally modest.

View Article: PubMed Central - HTML - PubMed

Affiliation: Accident Research Centre, Monash University, Melbourne, Australia. rod.mcclure@muarc.monash.edu.au

ABSTRACT

Background: There is a sound rationale for the population-based approach to falls injury prevention but there is currently insufficient evidence to advise governments and communities on how they can use population-based strategies to achieve desired reductions in the burden of falls-related injury. The aim of the study was to quantify the effectiveness of a streamlined (and thus potentially sustainable and cost-effective), population-based, multi-factorial falls injury prevention program for people over 60 years of age.

Methods: Population-based falls-prevention interventions were conducted at two geographically-defined and separate Australian sites: Wide Bay, Queensland, and Northern Rivers, NSW. Changes in the prevalence of key risk factors and changes in rates of injury outcomes within each community were compared before and after program implementation and changes in rates of injury outcomes in each community were also compared with the rates in their respective States.

Results: The interventions in neither community substantially decreased the rate of falls-related injury among people aged 60 years or older, although there was some evidence of reductions in occurrence of multiple falls reported by women. In addition, there was some indication of improvements in fall-related risk factors, but the magnitudes were generally modest.

Conclusions: The evidence suggests that low intensity population-based falls prevention programs may not be as effective as those that are intensively implemented.

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Related in: MedlinePlus

Hospitalisation rates for fall or related fracture for adults aged 60 years or older in Wide Bay (Wide Bay) and Northern Rivers (Northern Rivers) regions in comparison to statewide rates for Queensland (Qld) and New South Wales (NSW) **. ** Used the average of the Australia population between 1997 and 2004 for standardisation of rates (60-, 65-, 70-, 75-, 80+ years)
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Figure 2: Hospitalisation rates for fall or related fracture for adults aged 60 years or older in Wide Bay (Wide Bay) and Northern Rivers (Northern Rivers) regions in comparison to statewide rates for Queensland (Qld) and New South Wales (NSW) **. ** Used the average of the Australia population between 1997 and 2004 for standardisation of rates (60-, 65-, 70-, 75-, 80+ years)

Mentions: The average annual age-standardised morbidity rates for fracture with a fall coded as an external cause also were quite similar for the two states, at 146.0 per 100,000 for NSW and 148.3 per 100,000 for QLD from 1997-2005. However, again, Northern Rivers experienced a lower rate of hospitalisation throughout the time period at 91.3 per 100,000 compared to 128.8 per 100,000 for Wide Bay, although both locations showed increases in fall-related mortality starting around 2001. Most noteworthy, the morbidity rate in Northern Rivers was roughly 70% lower than its state-based rates before 2000, but was only 33% lower during the last couple of years of the intervention period (Figure 2). Trends were similar when analysed separately for men and for women, although women had much higher rates of fall-related fractures (data not shown).


The population approach to falls injury prevention in older people: findings of a two community trial.

McClure RJ, Hughes K, Ren C, McKenzie K, Dietrich U, Vardon P, Davis E, Newman B - BMC Public Health (2010)

Hospitalisation rates for fall or related fracture for adults aged 60 years or older in Wide Bay (Wide Bay) and Northern Rivers (Northern Rivers) regions in comparison to statewide rates for Queensland (Qld) and New South Wales (NSW) **. ** Used the average of the Australia population between 1997 and 2004 for standardisation of rates (60-, 65-, 70-, 75-, 80+ years)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2836986&req=5

Figure 2: Hospitalisation rates for fall or related fracture for adults aged 60 years or older in Wide Bay (Wide Bay) and Northern Rivers (Northern Rivers) regions in comparison to statewide rates for Queensland (Qld) and New South Wales (NSW) **. ** Used the average of the Australia population between 1997 and 2004 for standardisation of rates (60-, 65-, 70-, 75-, 80+ years)
Mentions: The average annual age-standardised morbidity rates for fracture with a fall coded as an external cause also were quite similar for the two states, at 146.0 per 100,000 for NSW and 148.3 per 100,000 for QLD from 1997-2005. However, again, Northern Rivers experienced a lower rate of hospitalisation throughout the time period at 91.3 per 100,000 compared to 128.8 per 100,000 for Wide Bay, although both locations showed increases in fall-related mortality starting around 2001. Most noteworthy, the morbidity rate in Northern Rivers was roughly 70% lower than its state-based rates before 2000, but was only 33% lower during the last couple of years of the intervention period (Figure 2). Trends were similar when analysed separately for men and for women, although women had much higher rates of fall-related fractures (data not shown).

Bottom Line: The aim of the study was to quantify the effectiveness of a streamlined (and thus potentially sustainable and cost-effective), population-based, multi-factorial falls injury prevention program for people over 60 years of age.The interventions in neither community substantially decreased the rate of falls-related injury among people aged 60 years or older, although there was some evidence of reductions in occurrence of multiple falls reported by women.In addition, there was some indication of improvements in fall-related risk factors, but the magnitudes were generally modest.

View Article: PubMed Central - HTML - PubMed

Affiliation: Accident Research Centre, Monash University, Melbourne, Australia. rod.mcclure@muarc.monash.edu.au

ABSTRACT

Background: There is a sound rationale for the population-based approach to falls injury prevention but there is currently insufficient evidence to advise governments and communities on how they can use population-based strategies to achieve desired reductions in the burden of falls-related injury. The aim of the study was to quantify the effectiveness of a streamlined (and thus potentially sustainable and cost-effective), population-based, multi-factorial falls injury prevention program for people over 60 years of age.

Methods: Population-based falls-prevention interventions were conducted at two geographically-defined and separate Australian sites: Wide Bay, Queensland, and Northern Rivers, NSW. Changes in the prevalence of key risk factors and changes in rates of injury outcomes within each community were compared before and after program implementation and changes in rates of injury outcomes in each community were also compared with the rates in their respective States.

Results: The interventions in neither community substantially decreased the rate of falls-related injury among people aged 60 years or older, although there was some evidence of reductions in occurrence of multiple falls reported by women. In addition, there was some indication of improvements in fall-related risk factors, but the magnitudes were generally modest.

Conclusions: The evidence suggests that low intensity population-based falls prevention programs may not be as effective as those that are intensively implemented.

Show MeSH
Related in: MedlinePlus