Table 1 Description of the ProF-Cog intervention specifying assessment and intervention to address specified fall risk factors
Risk factor | Gait and balance impairment | Medication | Medical conditions | Cognitive impairment | Behavioural and psychiatric |
|---|---|---|---|---|---|
Risk factor identified in Whitney et al. [5] | Unable to stand 10 s with eyes closed | Antidepressant or hypnotic/anxiolytic medication | N/a | Cognitive function Attention and concentration | FIBS, GAS, NPI |
How was it assessed in the MFRA? | Able to rise from a chair without assistancea | List of medication and doses | List of medical conditions Falls history Lying /standing BP Neurological and musculoskeletal examination | ACE-R at baseline | FIBS and NPI-NH at baseline |
Recommended intervention | Gait and balance exercises Check and maintenance of walking aids Provision of 3 pairs of hip protectors | Geriatrician review (with possible CGA) if using psychotropic drugs. | Geriatrician review (with possible CGA) if Undiagnosed cognitive impairment, dizziness, unexpected falls, orthostatic hypotension, agitated or anxious behaviours. | Environmental assessment Advice of environmental safety and optimising participation on ADLs Pool activity level and advice on participation in meaningful activities | Dementia care mapping and resulting action plan. Bed and chair sensors |
Intervention not required if | Bedbound Unable to rise from a chair Unable to follow very simple commands (i.e. get up from the chair) | No culprit medications. | No relevant medical conditions identified at assessment | All participants included | No evidence of impulsivity, wandering, anxiety or agitation. |
Proportion offered intervention | Exercise = 69% Hip protectors = 61% | 33% | 49% | 100% | DCM = 37% Sensors =4% |
Uptake of the interventionb | Completed exercise = 30% Hip protectors (agreed to wear) = 46% | - | - | - | - |