Effectiveness of Personalized Multifactorial Fall Risk Assessment and Intervention in Reducing Fall Rates Among Older Adults: A Retrospective Study

Abstract

Objective: This study aimed to investigate the effectiveness of personalized multifactorial fall risk assessment and intervention in reducing the incidence of recurrent falls after one year. Materials and Methods: This retrospective study reviewed medical records from the Geriatric Rehabilitation Clinic at Siriraj Hospital, including data from patients with a history of falls (fallers) or gait instability (non-fallers) between April 2016 and April 2021. Upon entering the clinic, older patients received personalized multifactorial fall risk assessment and intervention. Functional mobility was also evaluated using the Timed Up and Go (TUG) test, Functional Reach, and 30-second Chair Stand test. Fallers were followed for one year, and classified into recurrent fallers or zero-fallers based on whether they experienced at least one fall during the follow-up period. Results: Of the 134 patients initially reviewed, 105 met the criteria for analysis. The cohort was predominantly female (65.5%) with an average age of 81.5 years (SD 6.8). Common risk factors included hypertension, back/leg pain, and cognitive impairment. After 12 months, 27.4% of fallers experienced recurrent falls. Sedative medication use was significantly associated with increased fall risk (OR 4.15[1.5, 11.44]; P < 0.05). Other risk factors were not statistically significant. The fall rate reduced from 80% to 27.4% following personalized intervention. Conclusion: Personalized multifactorial fall risk assessment and intervention significantly decreased the fall rate among older patients. Sedative medications were notably linked to increased fall risk, highlighting the need for careful medication management and targeted fall prevention strategies.