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Tailored interventions to prevent functional decline after a Sentinel Fall presenting to the Emergency Department
Tania Zieschang1, Laura Himmelmann1, Nina Marie Schmidt1
1Geriatric Medicine, Department for Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Ammerländer Heerstraße 114-118, Oldenburg, 26129, Germany.
This study implements an individualized falls prevention program in the emergency department (ED) for older adults, aiming to reduce recurrent falls and functional decline. Findings will inform scalable models for secondary falls prevention in clinical settings.
Area of Science:
- Geriatric Medicine
- Public Health
- Implementation Science
Background:
- Falls are a major cause of emergency department visits for older adults, often leading to functional decline.
- Existing falls prevention strategies are underutilized in emergency department settings.
- The iSeFallED study builds on prior research to implement a novel secondary falls prevention program within the emergency department.
Purpose of the Study:
- To implement and evaluate an individualized secondary falls prevention program in the emergency department (ED) for older adults post-fall.
- To assess the feasibility and efficacy of integrating comprehensive geriatric assessment, tailored exercises, and wearable sensor monitoring.
- To refine falls prevention strategies using participatory methods and machine learning analysis of sensor data.
Main Methods:
- A pragmatic mixed-methods implementation trial enrolling adults aged 60+ presenting to the ED after a fall.
- Risk stratification algorithm to assign participants to tailored intervention arms (education, home-based, or supervised training).
- Data collection includes clinical assessments, wearable sensor data, and qualitative focus groups over 12 months.
Main Results:
- Primary outcome: change in activities of daily living.
- Secondary outcomes: recurrent falls, mobility, quality of life, and intervention adherence.
- Comparison with a historical control group (SeFallED study) to evaluate efficacy.
Conclusions:
- The iSeFallED study will determine the feasibility of initiating secondary falls prevention in the ED.
- It will evaluate the program's efficacy compared to standard care.
- The study aims to provide a scalable model for ED-integrated falls prevention.
