Cited by 415Balance, Gait, and Falls PreventionPharmaceutical Practices and Patient OutcomesDementia and Cognitive Impairment Research

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Multifactorial intervention after a fall in older people with cognitive impairment and dementia presenting to the accident and emergency department: randomised controlled trial

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Shaw, Fiona E, Bond, John, Richardson, David A, Dawson, Pamela, Steen, I Nicholas, McKeith, Ian G, Kenny, Rose Anne·2003·BMJ

DOI 10.1136/bmj.326.7380.73PMC PMC139930

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Abstract

Abstract Objective: To determine the effectiveness of multifactorial intervention after a fall in older patients with cognitive impairment and dementia attending the accident and emergency department. Design: Randomised controlled trial. Participants: 274 cognitively impaired older people (aged 65 or over) presenting to the accident and emergency department after a fall: 130 were randomised to assessment and intervention and 144 were randomised to assessment followed by conventional care (control group). Setting: Two accident and emergency departments, Newcastle upon Tyne. Main outcome measures: Primary outcome was number of participants who fell in year after intervention. Secondary outcomes were number of falls (corrected for diary returns), time to first fall, injury rates, fall related attendances at accident and emergency department, fall related hospital admissions, and mortality. Results: Intention to treat analysis showed no significant difference between intervention and control groups in proportion of patients who fell during 1 year's follow up (74% (96/130) and 80% (115/144), relative risk ratio 0.92, 95% confidence interval 0.81 to 1.05). No significant differences were found between groups for secondary outcome measures. Conclusions: Multifactorial intervention was not effective in preventing falls in older people with cognitive impairment and dementia presenting to the accident and emergency department after a fall. What is already known on this topic Multifactorial intervention prevents falls in cognitively normal older people living in the community and in those who present to the accident and emergency department after a fall Fall prevention strategies have not been tested by controlled trials in patients with cognitive impairment and dementia who fall What this study adds No benefit was shown from multifactorial assessment and intervention after a fall in patients with cognitive impairment and dementia presenting to the accident and emergency department The intervention was less effective in these patients than in cognitively normal older people

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Authors: Shaw, F. E., Bond, J., Richardson, D. A., Dawson, P., Steen, I. N., McKeith, I. G., & Kenny, R. A.
Affiliations: Royal Victoria Infirmary (GB)
Corresponding author: Shaw, Fiona E
ORCID: Kenny, Rose Anne
Venue: BMJ
Publisher: BMJ
Published: 2003-01-11
Volume: 326
Issue: 7380
Pages: 73
ISSN: 0007-1447 (ISSN-L)
0959-8138
1468-5833
DOI: 10.1136/bmj.326.7380.73
PMC: PMC139930
OpenAlex: W2118107628
Cited by: 414
References: 29
Citations by year: 2026: 9 · 2025: 5 · 2024: 14 · 2023: 12 · 2022: 9 · 2021: 9 · 2020: 12 · 2019: 16 · 2018: 29 · 2017: 13 · 2016: 19 · 2015: 11 · 2014: 21 · 2013: 20 · 2012: 25
FWCI: 67.70
Type: journal article
Language: en
Open access: green
europepmc.org
Licence: www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
Locations: BMJ (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Newcastle University ePrints (Newcastle Univesity)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Keywords: multifactorial intervention, fall prevention, falls in older adults, cognitive impairment, dementia, emergency department, injury rates, mortality
MeSH terms: Accidental Falls, Aged, Cognition Disorders, Dementia, Emergencies, Emergency Service, Hospital, Humans, Prospective Studies, Geriatric Assessment, Treatment Outcome

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Multifactorial intervention after a fall in older people with cognitive impairment and dementia presenting to the accident and emergency department: randomised controlled trial

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