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Disability Prevention Program Improves Life‐Space and Falls Efficacy: A Randomized Controlled Trial
Author(s) -
Liu Minhui,
Xue QianLi,
Gitlin Laura N.,
Wolff Jennifer L.,
Guralnik Jack,
Leff Bruce,
Szanton Sarah L.
Publication year - 2021
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.16808
Subject(s) - medicine , randomized controlled trial , tinetti test , confidence interval , physical therapy , odds ratio , activities of daily living , poison control , fear of falling , toileting , injury prevention , gerontology , balance (ability) , surgery , medical emergency , pathology
OBJECTIVES To evaluate the effects of a home‐based disability prevention program on life‐space and falls efficacy among low‐income older adults. DESIGN Single‐blind two‐arm randomized controlled trial. SETTING Participants' homes. PARTICIPANTS Participants were low‐income cognitively intact older adults (≥65 years old) with restricted daily activities. Our analytic sample for life‐space (n = 194) and falls efficacy (n = 233) varied as the life‐space measure was introduced 4 months after the trial began. INTERVENTION Up to six 1‐hour home visits with an occupational therapist; up to four 1‐hour home visits with a registered nurse; and up to $1,300 worth of home repairs, modifications, and assistive devices with a handyman, during a course of 4 months. MEASUREMENTS Life‐space was measured by the Homebound Mobility Assessment; falls efficacy was measured using the 10‐item Tinetti Falls Efficacy Scale at baseline and 5 months. RESULTS Participants were on average 75 years old, predominantly Black (86%) and female (85%–86%). Compared with participants in the control group, participants receiving the intervention were more likely to have improved versus decreased life‐space in areas of bathroom (adjusted odds ratio (OR) = 3.95; 95% confidence interval (CI) = 1.20–12.97), front or back porch, patio, or deck (adjusted OR = 2.67; 95% CI = 1.05–6.79), stairs (adjusted OR = 4.09; 95% CI = 1.34–12.48), leaving the house for any reason other than for health care (adjusted OR = 2.40; 95% CI = 1.01–5.73), and overall life‐space (adjusted OR = 2.15; 95% CI = 1.10–4.19). Participants who received the intervention also had an 11% improvement in falls efficacy in performing daily activities (exponentiated coefficient = 1.12; 95% CI = 1.04–1.21). CONCLUSION Life‐space and falls efficacy were improved through a multicomponent, person‐directed, home‐based disability prevention intervention. Findings suggest that this intervention should be translated into different settings to promote independent aging.