The primary aim of the proposed project is to compare the effectiveness of usual health care (UC), usual health care plus social visits (SV), and usual health care plus a targeted intervention strategy (TI) in reducing falls and improving stability, activity level, and confidence among vulnerable community elderly persons. Secondary aims include describing components of the TI strategy that are effective; describing the characteristics of subjects who appear to benefit from the TI strategy; describing the relationship between reduction in number of risk factors and occurrence of the outcomes; describing pertinent relationships among the outcomes; and comparing overall health care costs among the UC, SV, and TI groups. A matched cohort of physicians employed by a New Haven area health maintenance organization will be randomly allocated to the UC, SV, or TI groups. Then a random sample of 420 eligible patients of these physicians will be assigned to the group of their physician. All subjects will undergo a baseline evaluation by a nurse practitioner and physical therapist and will then be followed for one-year. The UC subjects will otherwise receive only their usual health care; the SV subjects will receive their usual health care plus a series of """"""""social visits"""""""". The TI subjects will receive a multidisciplinary risk abatement strategy targeted at impairments in vision, hearing, postural blood pressure, upper and lower extremity strength and ROM, feet, balance and gait, and simple ADLS as well as at medication usage and environmental fall hazards. Outcomes to be assessed include occurrence of falls and injuries, and changes in balance and gait (stability), activity and mobility level, and confidence (efficacy).

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01AG009087-04
Application #
2050577
Study Section
Aging Review Committee (AGE)
Project Start
1990-04-16
Project End
1995-06-30
Budget Start
1994-07-01
Budget End
1995-06-30
Support Year
4
Fiscal Year
1994
Total Cost
Indirect Cost
Name
Yale University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
082359691
City
New Haven
State
CT
Country
United States
Zip Code
06520
Ory, Marcia G; Lipman, Paula Darby; Karlen, Patricia L et al. (2002) Recruitment of older participants in frailty/injury prevention studies. Prev Sci 3:1-22
Tinetti, M E; McAvay, G; Claus, E (1996) Does multiple risk factor reduction explain the reduction in fall rate in the Yale FICSIT Trial? Frailty and Injuries Cooperative Studies of Intervention Techniques. Am J Epidemiol 144:389-99
Rossiter-Fornoff, J E; Wolf, S L; Wolfson, L I et al. (1995) A cross-sectional validation study of the FICSIT common data base static balance measures. Frailty and Injuries: Cooperative Studies of Intervention Techniques. J Gerontol A Biol Sci Med Sci 50:M291-7
Koch, M; Gottschalk, M; Baker, D I et al. (1994) An impairment and disability assessment and treatment protocol for community-living elderly persons. Phys Ther 74:286-94;discussion 295-8
Tinetti, M E (1994) Prevention of falls and fall injuries in elderly persons: a research agenda. Prev Med 23:756-62
Tinetti, M E; Baker, D I; McAvay, G et al. (1994) A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med 331:821-7
Buchner, D M; Hornbrook, M C; Kutner, N G et al. (1993) Development of the common data base for the FICSIT trials. J Am Geriatr Soc 41:297-308
Tinetti, M E; Baker, D I; Garrett, P A et al. (1993) Yale FICSIT: risk factor abatement strategy for fall prevention. J Am Geriatr Soc 41:315-20
Ory, M G; Schechtman, K B; Miller, J P et al. (1993) Frailty and injuries in later life: the FICSIT trials. J Am Geriatr Soc 41:283-96