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American Journal of Public Health, Vol. 84, Issue 11 1800-1806, Copyright © 1994 by American Public Health Association

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

E H Wagner, A Z LaCroix, L Grothaus, S G Leveille, J A Hecht, K Artz, K Odle and D M Buchner

Center for Health Studies, Group Health Cooperative of Puget Sound, Seattle, WA 98101.

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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Copyright © 1994 by the American Public Health Association