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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

Lookup NU author(s): Dr Fiona Shaw, Professor John Bond, Dr Nick Steen, Professor Ian McKeith, Professor Rose Anne Kenny

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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 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 the 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.


Publication metadata

Author(s): Shaw FE, Bond J, Richardson DA, Dawson P, Steen IN, McKeith IG, Kenny RA

Publication type: Article

Publication status: Published

Journal: British Medical Journal

Year: 2003

Volume: 326

Issue: 7380

Pages: 6

Print publication date: 01/01/2003

ISSN (print): 0959-535X

ISSN (electronic): 1756-1833

Publisher: BMJ Group

URL: http://dx.doi.org/10.1136/bmj.326.7380.73

DOI: 10.1136/bmj.326.7380.73


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