[Can we prevent falls in the elderly from primary care?].

OBJECTIVE

To determine the effectiveness of multifactorial intervention by Primary Care in the prevention of falls in the elderly who had fallen the year before.

DESIGN

Intervention study with a control group.

SETTING

Three clinics in a rural area.

SUBJECTS: 224 patients > or = 65 years, independent for mobility (113 in the intervention (IG) and 111 in the control (GC) group.

INTERVENTIONS: Intervention Group.

INITIAL ASSESSMENT: 1) Demographic data questionnaire, number, circumstances and consequences of falls, comorbidity and drugs. 2) Oriented examination. 3) Home risks assessment.

INTERVENTIONS: referred to cardiology if arrhythmia or bradycardia, referred for eye examination if changes in acute vision, recommendation for systems support if gait or balance problems, postural measures if orthostatic hypotension, behavioural measures in urinary incontinence and recommendations to modify home risks.

CONTROL GROUP: Questionnaire on: demographic data, number, circumstances and consequences of falls and medication use. They received normal medical care.

RESULTS

At one year 44% of the IG and 33% in the CG fell again (P=0.123). In the sub-group with more than one fall at the beginning of the study, 63% in the IG, and 56% in CG fell again (P=0.599). There were serious consequences in 6% of the IG compared to 14% in the CG (P=0.277).

CONCLUSIONS

Multifactorial intervention from primary care is not effective in reducing falls or for reducing the severity of their consequences.