J Med Assoc Thai 2002; 85 (2):215

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Strategy to Prevent Falls in the Thai Elderly : A Controlled Study Integrated Health Research Program for the Thai Elderly
Assantachai P Mail, Praditsuwan R , Chatthanawaree W , Pisalsarakij D , Thamlikitkul V

RUNGNIRAND PRADITSUWAN, M.D.**,
DUJPRATANA PISALSARAKU, B.Sc.*,
Instability or falls are one of the important warning symptoms of underlying serious illness
among the elderly, so many studies have concentrated on the risk factors for falls. However, a
study involving a strategic method to reduce the incidence of falls is the next step and is the main
objective of this study. 1 ,043 elderly subjects living in the urban area around Siriraj Hospital Medical
School, Bangkok, were recruited, 585 of them were allocated to the study group and 458 subjects
to the control group. A leaflet containing information on important risk factors of falls within their
community was enclosed with a follow-up postcard in the study group only. In addition, this par-
ticular group was allowed free access to the geriatric clinic at Siriraj Hospital if there was any
health problem. All of them received a postcard asking about any falls which had occurred over
the previous 2 months on 6 occasions and a telephone call if the postcards were not returned to
the team. The percentage of elderly who kept in contact was 92.5 per cent, 90.6 per cent, 89.3 per
cent, 89.2 per cent, 86.2 per cent and 85.45 per cent for the first to final follow-up respectively.
After one year of longitudinal study, the overall incidence of falls was 6.6 per cent in the study
group and 10.1 per cent in the control group. The incidence of falls began to show a statistically
significant difference between the two groups at the fourth and sixth episodes of follow-up (P
=
0.002 and 0.004). The Kaplan-Meier survival analysis also revealed a statistically significant dif-
ference in the incidence of falls between the two groups (P =0.01). In conclusion, the incidence
of falls was significantly reduced in the study group and a repeated campaign to alert the elderly
to the risk of falling is a cost-effective way of fall prevention among the healthy elderly in the
community.
Key word : Prevention, Fall, Elderly

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