Do home adaptation interventions help to reduce emergency fall admissions? A national longitudinal data-linkage study of 657,536 older adults living in Wales (UK) between 2010 and 2017



Hollinghurst, Joe, Daniels, Helen, Fry, Richard, Akbari, Ashley, Rodgers, Sarah ORCID: 0000-0002-4483-0845, Watkins, Alan, Hillcoat-Nalletamby, Sarah, Williams, Neil, Nikolova, Silviya, Meads, David
et al (show 1 more authors) (2022) Do home adaptation interventions help to reduce emergency fall admissions? A national longitudinal data-linkage study of 657,536 older adults living in Wales (UK) between 2010 and 2017. AGE AND AGEING, 51 (1). afab201-.

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Abstract

<h4>Background</h4>falls are common in older people, but evidence for the effectiveness of preventative home adaptations is limited.<h4>Aim</h4>determine whether a national home adaptation service, Care&Repair Cymru (C&RC), identified individuals at risk of falls occurring at home and reduced the likelihood of falls.<h4>Study design</h4>retrospective longitudinal controlled non-randomised intervention cohort study.<h4>Setting</h4>our cohort consisted of 657,536 individuals aged 60+ living in Wales (UK) between 1 January 2010 and 31 December 2017. About 123,729 individuals received a home adaptation service.<h4>Methods</h4>we created a dataset with up to 41 quarterly observations per person. For each quarter, we observed if a fall occurred at home that resulted in either an emergency department or an emergency hospital admission. We analysed the data using multilevel logistic regression.<h4>Results</h4>compared to the control group, C&RC clients had higher odds of falling, with an odds ratio (OR [95% confidence interval]) of 1.93 [1.87, 2.00]. Falls odds was higher for females (1.44 [1.42, 1.46]), older age (1.07 [1.07, 1.07]), increased frailty (mild 1.57 [1.55, 1.60], moderate 2.31 [2.26, 2.35], severe 3.05 [2.96, 3.13]), and deprivation (most deprived compared to least: 1.16 [1.13, 1.19]). Client fall odds decreased post-intervention; OR 0.97 [0.96, 0.97] per quarter. Regional variation existed for falls (5.8%), with most variation at the individual level (31.3%).<h4>Conclusions</h4>C&RC identified people more likely to have an emergency fall admission occurring at home, and their service reduced the odds of falling post-intervention. Service provisioning should meet the needs of an individual and need varies by personal and regional circumstance.

Item Type: Article
Uncontrolled Keywords: older people, falls prevention, frailty, falls
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Population Health
Depositing User: Symplectic Admin
Date Deposited: 26 May 2022 15:11
Last Modified: 10 Feb 2024 02:05
DOI: 10.1093/ageing/afab201
Open Access URL: https://doi.org/10.1093/ageing/afab201
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3155542