By Joene Hendry

NEW YORK (Reuters Health) - Elderly individuals at high risk of falling were able to cut this risk in half by following advice from 'falls clinics', Australian, researchers report in the Journal of the American Geriatrics Society.

Dr. Keith D. Hill and colleagues explain that more than three-quarters of the people attending the falls clinics had fallen at least once and 63 percent had fallen multiple times. "Despite these factors, the [clinics'] multidisciplinary assessment and management/referral approach reduced falls and fall injuries by around 50 percent," Hill told Reuters Health.

Hill, of the National Ageing Research Institute in Parkville, Victoria, and colleagues evaluated the efficacy of the clinics' interventions among 454 people, average age 78 years. Most lived at home either alone or with a spouse or caregiver, and 73 percent were female, the researchers report.

They compared participants' balance, mobility, leg strength, walking speed, measures of physical function, medication use, blood pressure differences while lying and standing, and the incidence of falls during initial assessments and 6 months after referral to a falls clinic.

Clinic teams developed individualized interventions based on each client's initial assessment. These interventions most commonly included home safety visits to recommend changes to the home environment, home and group exercise programs, changes in walking aids, alterations in footwear, and podiatric assessment for feet problems, Hill said.

On average, 74 percent of the study participants followed the recommendations of the falls clinics.

Among the 254 participants assessed after 6 months, the number of falls, falls causing injuries, and falls needing medical attention had been reduced by more than 50 percent, the investigators note.

The clients "also achieved small but significant improvements in measures of balance, mobility, and leg strength," Hill said.

These findings provide positive support for the effectiveness of the falls clinic approach, and should be further evaluated through a randomized controlled trial, the researchers conclude.

SOURCE: Journal of the American Geriatrics Society, April 2008.

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