Implementation of a case management-based intervention focused on preventing falls in older people with high risk of falls: a randomized clinical trial

• Grant number: 24/10699-6
• Support Opportunities: Regular Research Grants
• Start date: April 01, 2025
• End date: March 31, 2028
• Field of knowledge: Health Sciences - Collective Health - Preventive Medicine
• Principal Investigator: Juliana Hotta Ansai
• Grantee: Juliana Hotta Ansai
• Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil
• Associated researchers: Camila Bianca Falasco Pantoni ; Daiene de Morais ; Daniela Godoi Jacomassi ; Jean Roberto Ponciano ; Karina Gramani Say ; Letícia Bojikian Calixtre ; Leticia Pimenta Costa Guarisco ; Maria Joana Duarte Caetano ; Paulo Henrique Silva Pelicioni ; Stephen Ronald Lord ; Verena de Vassimon Barroso Carmelo
• Associated scholarship(s): 25/07579-1 - Technical training for case management project focusing on fall prevention in older people at high risk of falls: intervention, BP.TT

Abstract

Introduction: Although there is evidence on multifactorial interventions to prevent falls, there is a lack of randomized clinical trials involving good methodological quality and blind assessment for older people with high risk of falls in the Brazilian context. Objective: To implement an intervention based on case management focused on preventing falls in older people with high risk of falls in the municipality of São Carlos and nearby municipalities. Method: A single-blind randomized clinical trial will be carried out with community-dwelling older people with high risk of falls. Participants will be distributed into two parallel groups (Intervention Group and Control Group) (n=100). The Control Group will carry out the physical exercise protocol for 16 weeks, twice a week on site in their Health Unit. The Intervention Group, in addition to the physical exercise protocol, will undergo case management carried out remotely, which will involve multidimensional assessment, explanation of the identified fall risk factors, creation of an intervention proposal based on the identified risks, preparation of an individualized falls intervention plan, monitoring and review of the plan. All volunteers will be evaluated initially, after 16 weeks of intervention, after follow-up of 6 months and 12 months. The assessment will consist of clinical and sociodemographic data, neuropsychological measures (cognitive functions, dual task, with fNIRS if acquired, depressive and anxiety symptoms and fear of falling), falls and minimum clinically relevant difference. Furthermore, based on the reassessment, volunteers will respond about adherence and satisfaction with interventions and adherence to recommendations. For data analysis by intention to treat, a significance level of ±=0.05 will be adopted. Expected results: It is expected to identify improvement in neuropsychological risk factors, good adherence, adherence to recommendations and satisfaction with the case management intervention. With this, we hope to encourage the possibility of implementing this type of intervention for older people at high risk of falls. (AU)