Remote fall prevention showed no clear benefit in at-risk older adults
A randomized trial followed 660 adults aged 65 and older for one year, comparing nurse-led remote fall assessments with usual primary care.
Limit: Standard-care providers could also use STEADI, shrinking differences between groups
Edited by Boris Djordjevic · AgingResearch.News
A randomized trial analyzed 660 adults aged 65 and older who screened as having increased fall risk at five primary care clinics. Their average age was 75.8; 67.7% were female and 56.1% were non-Hispanic White. Primary care professionals were randomized to usual care or an approach in which a nurse assessed patients by video or phone and sent fall-prevention recommendations. Clinicians decided which recommendations to implement.
Researchers tracked falls through patient reports and medical records over one year. The intervention group started with higher fall-risk screening scores. After accounting for initial fall risk, researchers found no statistically clear differences in fall outcomes. They also found no clear differences in fall-related service use or medication use. The analysis included participants whether or not they completed the assessment.
Why it matters
Falls are a leading cause of injury and death in older adults. The trial addressed whether remote assessments could support fall prevention through primary care.
Caveats
Low recruitment, low baseline fall rates and unmeasured adherence may have affected the results, the authors said. The findings may not apply to people unable to answer screening questions in English or without someone available to assist during assessment.
From the paper
- Participants
A total of 3,722 patients were screened, 3,002 were excluded, and 720 patients were enrolled in the study.
- Who took part
The study population consisted of adults aged 65 years and older with a non-acute primary care visit scheduled at one of the five participating primary care clinics.
- Ages
The mean age was 75.8 (Standard Deviation [SD]=6.8, results not shown).
- Sex
The sample was majority female (67.7%), under 80 years of age (73.6%), and non-Hispanic or Latino White (56.1%).
- Result
The self-reported fall rate in the intervention arm was 46.5% higher (RR = 1.465; 95% CI: 1.018–2.110) than the SOC arm in unadjusted models.
- Limitation
First, this study was conducted during the COVID-19 pandemic, which may have affected recruitment, participant engagement, and the generalizability of results to non-pandemic settings.
- Falls
However, after adjusting for SIS score (model 1) and SIS score, demographic characteristics, and EHR falls at baseline (model 2) these differences were no longer significant (RR = 1.098, 95% CI: 0.792–1.524 and RR = 1.091, 95% CI: 0.797–1.493, respectively).
- Confirmed falls
The treatment group had consistently lower odds of experiencing at least one confirmed fall recorded in the EHR, with a 10.6% reduction in the unadjusted analysis (OR = 0.894, 95% CI: 0.473–1.690), and 24.4% reduction after adjusting for SIS (model 1) (OR = 0.756, 95% CI: 0.393–1.452), and an 18.8% reduction in model 2 (OR = 0.812, 95% CI: 0.418–1.574), although none of these differences achieved statistical significance due to wide confidence intervals that included unity …
Quoted word for word from the full text on PubMed Central.
The paper
Centers for Disease Control and Prevention
The Gerontologist, Dec 6, 2025, Open access, accepted manuscript