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Multifactorial fall prevention for pairs of frail community-dwelling older fallers and their informal caregivers: a dead end for complex interventions in the frailest fallers


Faes, Miriam C., Reelick, Miriam F., Melis, René J., Borm, George F., Esselink, Rianne A., Rikkert, Marcel G. Olde


Journal Of The American Medical Directors Association, Volume: 12, No.: 6, Pages.: 451-458

Year of Publication



Objective: To assess whether a multifactorial fall prevention program was more effective than usual geriatric care in preventing falls and reducing fear of falling in frail community-dwelling older fallers, with and without cognitive impairment, and in alleviating subjective caregiver burden in caregivers.; Design, Setting, and Participants: A randomized, 2 parallel-group, single-blind, multicenter trial conducted in 36 pairs of frail fallers, who were referred to a geriatric outpatient clinic after at least 1 fall in the past 6 months, and their informal caregivers.; Intervention: Groups of 5 pairs of patients and caregivers received 10 twice-weekly, 2-hour sessions with physical and psychological components and a booster session.; Measurements: The primary outcome was the fall rate during a 6-month follow-up. Additionally, we measured fear of falling and subjective caregiver burden. Data on the secondary outcome measures were collected at baseline, directly after, and at 3 and 6 months after the last session of the intervention.; Results: Directly after the intervention and at the long-term evaluation, the rate of falls in the intervention group was higher than in the control group, although these differences were not statistically significant (RR = 7.97, P = .07 and RR = 2.12, P = .25, respectively). Fear of falling was higher in the intervention group, and subjective caregiver burden did not differ between groups.; Conclusion: Although we meticulously developed this pairwise multifactorial fall prevention program, it was not effective in reducing the fall rate or fear of falling and was not feasible for caregivers, as compared with regular geriatric care. Future research initiatives should be aimed at how to implement the evidence-based principles of geriatric fall prevention for all frail fallers rather than developing more complex interventions for the frailest.; Copyright © 2011 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

Bibtex Citation

@article{Faes_2011, doi = {10.1016/j.jamda.2010.11.006}, url = {}, year = 2011, month = {jul}, publisher = {Elsevier {BV}}, volume = {12}, number = {6}, pages = {451--458}, author = {Miriam C. Faes and Miriam F. Reelick and Ren{'{e}} J. Melis and George F. Borm and Rianne A. Esselink and Marcel G. Olde Rikkert}, title = {Multifactorial Fall Prevention for Pairs of Frail Community-Dwelling Older Fallers and their Informal Caregivers: A Dead End for Complex Interventions in the Frailest Fallers}, journal = {Journal of the American Medical Directors Association} }


accidental falls, aged, aged, 80 and over, ambulatory care, caregivers, falling, falls, fear, female, frail elderly, humans, male, methods, middle aged, netherlands, of, outcome assessment (health care), prevention & control, residential facilities, safety management

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Randomised Controlled Trial

Type of Outcomes

Carer Burden (instruments measuring burden), Other, Prevention and/or management of co-morbidities



Type of Interventions

Treatment/prevention of co-morbidities or additional risks


Fall Prevention