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Effect of a Multifactorial Fall Injury Prevention Intervention on Patient Well-Being: The STRIDE Study.

Thomas M Gill¹, Shalender Bhasin², David B Reuben³

¹Yale Claude D. Pepper Older Americans Independence Center, Yale University, New Haven, Connecticut, USA.

Journal of the American Geriatrics Society

|October 10, 2020

Summary

The STRIDE study found that a multifactorial intervention did not significantly improve older adults' well-being, including anxiety and depression, despite reducing self-reported falls. This intervention aimed to reduce fall injuries but showed minimal impact on overall patient well-being.

Keywords:

fall injury prevention older persons pragmatic trials well-being

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Area of Science:

Gerontology
Public Health
Clinical Intervention Research

Background:

The Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) study investigated a multifactorial intervention for older adults at high risk of falls.
Previous findings indicated a nonsignificant reduction in serious fall injuries but a significant reduction in self-reported fall injuries.

Purpose of the Study:

To evaluate the impact of the STRIDE intervention on patient well-being.
Key well-being indicators assessed included concern about falling, anxiety, depression, physical function, and disability.

Main Methods:

A pragmatic cluster-randomized trial involving 5,451 community-living older adults at high risk for fall injuries.
A subsample of 743 participants aged 75 and older were assessed using validated scales for well-being at baseline, 12, and 24 months.

Main Results:

While the intervention group showed slightly lower mean scores for anxiety and depression at 12 and 24 months, these differences were quantitatively small.
No clinically meaningful improvements were observed in concern about falling, physical function, or disability between the intervention and control groups.
A statistically significant improvement was found only in depression scores, favoring the intervention group, but the difference was below the threshold for minimal clinical importance.

Conclusions:

The multifactorial intervention tested in the STRIDE study was not associated with clinically meaningful improvements in the overall well-being of older adults.
The findings suggest that while interventions may impact specific fall-related outcomes, broader well-being improvements require further investigation.