PREVENTING DISABILITY AND FALLS IN OLDER ADULTS - A POPULATION-BASED RANDOMIZED TRIAL

Objectives. Because preventing disability and falls in older adults is a national priority, a randomized controlled trial was conducted to t est a multicomponent intervention program. Methods. From a random samp le of health maintenance organization (HMO) enrollees 65 years and old er, 1559 ambulatory seniors were randomized to one of three groups: a nurse assessment visit and follow-up interventions targeting risk fact ors for disability and falls (group 1, n = 635); a general health prom otion nurse visit (group 2, n = 317); and usual care (group 3, n = 607 ). Data collection consisted of a baseline and two annual follow-up su rveys. Results. After 1 year, group 1 subjects reported a significantl y lower incidence of declining functional status and a significantly l ower incidence of falls than group 3 subjects. Group 2 subjects had in termediate levels of most outcomes. After 2 years of follow-up, the di fferences narrowed. Conclusions. The results suggest that a modest, on e-time prevention program appeared to confer shortterm health benefits on ambulatory HMO enrollees, although benefits diminished by the seco nd year of follow-up. The mechanisms by which the intervention may hav e improved outcomes require further investigation.