Intervention for Fall Prevention in Institutionalized Frail Elderly

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  • 介護老人保健施設入所者の転倒予防介入効果検証
  • 介護老人保健施設入所者の転倒予防介入効果検証 : 準ランダム化比較試験
  • カイゴロウジン ホケン シセツ ニュウショシャ ノ テントウ ヨボウ カイニュウ コウカ ケンショウ : ジュンランダムカ ヒカク シケン
  • ～準ランダム化比較試験～
  • Controlled Clinical Trail

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Abstract

【Purpose】The purpose of this study was to measure the effectiveness of a three-month intervention using exercise or vitamin D supplementation on fall reduction among institutionalized frail elderly.【Methods】Sixty-eight participants (49 female, mean age: 84.3±9.2 years) were institutionalized frail elderly. The study was randomized, controlled, and non-blinded using a 3-group design. The exercise group received resistance and balance exercise for 30 minutes per week. The nutrition group consumed vitamin D (900 IU/day) in the form of jelly and a supplement. The control group was provided usual care. The intervention period was three months, and falls were recorded for a four-month follow-up period. Baseline data included age, sex, height, weight, BMI, and cognitive function. To verify the intervention effect, skeletal muscle mass index (SMI), grip strength, 25-hydroxy vitamin-D and FIM were measured. The primary endpoint was the incidence of falls, which was analyzed using Kaplan-Meier analysis. A two-way analysis of variance was used to compare pre- and post-test measurements.【Results】Nine participants did not complete the study (85.3% retention rate). In the two-way analysis of variance, group-time interactions were significant for 25-hydroxy-D, while the other outcome measures were not significantly different between the three groups. During the follow-up period, there were five falls in the control group (22.7%), eight falls in the exercise group (47.1%), and two falls in the nutrition group (10.0%). Kaplan-Meier analysis revealed a significant reduction in falls in the nutrition group in comparison with the exercise group.【Conclusion】The results suggest that vitamin D intake maintains the effects on reducing falls for 4months among institutionalized frail elderly.

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