Weekly Research Highlight in Fall Prevention

This weekly blog post aims to highlight articles published during the week regarding fall prevention. This week we take a look at the i-FOCIS randomised controlled trial. A tailored exercise and home hazard reduction for fall prevention in older people with cognitive impairment.

Abstracts for these studies can be found here

Tailored exercise and home hazard reduction for fall prevention in older people with cognitive impairment: the i-FOCIS randomized controlled trial 
Taylor ME, Wesson J, Sherrington C, Hill KD, Kurrle S, Lord SR, Brodaty H, Howard K, O’Rourke SD, Clemson L, Payne N, Toson B, Webster L, Savage R, Zelma G, Koch C, John B, Lockwood K, Close JCT. J. Gerontol. A Biol. Sci. Med. Sci. 2020; ePub(ePub): ePub
DOI 10.1093/gerona/glaa241 PMID 32949456
There have been few studies that have investigated effective strategies for fall prevention in people with cognitive impairment. People with dementia are more likely to fall than healthy older adults. The consequences of falls for people with dementia are also more severe with an increased risk of hip fracture and a greater likelyhood of moving into residential care following a fall. This study aimed to determine whether a  home-based, individually tailored exercise program combined with an occupational therapy home hazard reduction program could reduce the rate of falls in community-dwelling older people with cognitive impairment.
The intervention included a home assessment conducted by an occupationa therapist in order to identify fall-related home hazards and home safety recommendations were then made to minimise or eliminate these hazards. A physiotherapist delivered a home based exercise intervention based on the OTAGO and WEBB programs.
They found that the home-based intervention involving exercise and a home hazard reduction program for community-dwelling people with cognitive impairment did not significantly reduce the rate or risk of falls and did not significantly improve relevant fall risk factors. A sensitivity analyses adjusting for follow-up and baseline differences known to increase fall risk, indicated there was a significant reduction in the proportion of multiple fallers in the intervention group, and planned subgroup analyses revealed the intervention significantly reduced the rate of falls in participants with better baseline physical function.