Injuries and frailty are important health problems in the elderly in terms of the mortality, morbidity, and hospitalization, as well as the psychological trauma, and restricted lifestyle which can be their result. This is a proposal to be the coordinating center for a multi-center study of up to eight intervention strategies to reduce injuries and frailty in the elderly. While several studies plus two NIA, NCNR, and CDC sponsored workshops have focused on these issues, as pointed out in the RFA prompting this proposal, a major drawback to much of the previous work has been """"""""the lack of clearly defined population groups, rigorous research designs, and standard definitions for fall events, fall-related injuries and other related outcomes"""""""". Since six to eight clinical sites with diverse approaches will be chosen for this study, a major goal of the coordinating center will be to provide the scientific rigor, definitional clarity, and adjustments to the designs required to overcome these deficits. During the protocol refinement period (phase 1), our primary job will be to make sure that these become a coherent group of related intervention studies whose results can complement each other, rather than one more set of pilot studies which can only be contrasted in the most superficial way. Specifically, we will attempt to maximize the common portions of the studies, so that whenever possible, common instruments, common measures, common protocols, and common data analysis strategies are implemented. We will design the forms and implement a data management system for the entry of the common portions of the studies. During the intervention period (phase 2), our primary tasks will be to monitor the protocols and manage the common data, as well as conduct the pre-planned meta-analysis of all studies.
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