Community-based interventions to reduce falls among older adults in Taiwan - long time follow-up randomised controlled study.

AIMS: The aim of the study was to examine the effects of different interventions that are used to prevent falls. These were education, Tai Chi Chuan and education plus Tai Chi Chuan; the study involved a five-month implantation period and a one-year follow-up period. BACKGROUND: With advancing years, a fall can be very serious and an increased number of falls/re-falls among older adults has been noted. Hence, both education about risk factors and balance exercise programs such as Tai Chi Chuan may help to prevent falls. DESIGN: This study adopted a randomised case-controlled design with a two-by-two factorial approach. It included three intervention groups and one control group in a community-based program. METHODS: Cluster-randomised sampling was used and four villages in Taiwan City were selected. Three interventions groups and one control group were involved over five-months from late July 2000-January 2001 and each participant was followed up one year later (n = 163). RESULTS: The intervention involving education plus Tai Chi Chuan resulted in a statistically significant reduction in falls and the risk factors of falls over the five-month intervention. After one-year follow-up, participants receiving any one of the interventions showed a reduction in falls compared with the control group. CONCLUSIONS: Tai Chi Chuan was able to improve gait balance significantly. Education may also help participants to prevent falls-by eliminating related risk factors present in their environment. However, it was found that at the one-year follow-up, any one of the three interventions had reduced falls significantly. RELEVANCE TO CLINICAL PRACTICE: The prevention of falls among older adults seems to needs multiple interventions. Education plus Tai Chi Chuan has both an immediately and a long-term effect and it is possible that a shorter intervention period using this approach would also be successful.