Forum on Healthy Ageing Tuesday 28th January 2020, 10.00am to 4.00pm
UNSW Business School, Lecture Theatre 119
College Rd, UNSW Sydney, Kensignton, NSW Co-hosted by CEPAR and the UNSW Ageing Futures Institute, the aim of this forum is to provide a deeper understanding of healthy ageing.
The Forum will feature the following confirmed speakers:
• Kaarin Anstey (Director, UNSW Ageing Futures Institute, and CEPAR Chief Investigator)
• John Beard (former Director of the World Health Organisation's Department of Ageing and Life Course, and now a professorial fellow at CEPAR, UNSW Sydney)
• Julie Byles (CEPAR Associate Investigator, University of Newcastle)
• Denzil Fiebig (CEPAR Associate Investigator, UNSW Sydney)
• Brenda Gannon (CEPAR Affiliate, the University of Queensland)
• Vas Yiengprugsawan (CEPAR Senior Research Fellow, UNSW Sydney)
NSW Falls Network Rural Forum FWNSW LHD Wednesday 25th March 2020, 9.30am to 3.00pm
Musicians Club, 276 Crystal St, Broken Hill This forum will inspire & motivate care staff to provide high quality evidenced based care with a focus on strategies to reduce risk & harm from falls. There will be discussion on the latest research and improvement science approach to falls prevention and management including Comprehensive care (Standard 5) with a focus on strategies to reduce risk & harm from falls and falls preventative measures.
Who should attend: Allied Health, Nursing and Medical Staff from Hospital, Community and Residential Aged Care Settings and Allied Health, Exercise Physiology, Nursing and Medical Students Registrations at My Health Learning will open mid-January for external registrations email firstname.lastname@example.org
Registrations close 13th March 2020
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NSW Falls Prevention Network Forum
Friday 15th May 2020
Wesley Conference Centre, 220 Pitt St, Sydney Speakers Include
Pam Albany Guest Lecture: Professor Kaarin Anstey, Senior Principal Research Fellow, NeuRA: Healthy cognitive ageing
Professor Jacqueline Close, Consultant Geriatrician POWH, FBIRC NeuRA: Dementia and preventing falls
Professor Stephen Lord, Senior Principal Research Fellow, Falls, Balance and Injury Research Centre (FBIRC) NeuRA: Falls prevention research update
An update to the cochrane review on exercise as a single intervention preventing falls in older people living in the community. A review of 59 studies found that exercise reduces the rate of falls by 23% (rate ratio (RaR) 0.77, 95% CI 0.71 to 0.83; 12 981 participants, 59 studies; high-certainty evidence). The evidence is clear and effective programmes should now be implemented.
Evaluation of RESPOND, a patient-centred program to prevent falls in older people presenting to the emergency department with a fall: A randomised controlled trial
Anna Barker, Peter Cameron, Leon Flicker, Glenn Arendts, Caroline Brand, Christopher Etherton-Beer, Andrew Forbes, Terry Haines, AnneMarie HillI, Peter Hunter, Judy Lowthian, Samuel R. Nyman, Julie Redfern, De Villiers Smit, Nicholas Waldron, Eileen Boyle, Ellen MacDonald, Darshini Ayton, Renata Morello, Keith HillI PLoS Med 16(5): e1002807. https://doi.org/10.1371/journal.pmed.1002807
Falls are a leading reason for older people presenting to the emergency department (ED), and many experience further falls. Little evidence exists to guide secondary prevention in this population. This randomised controlled trial (RCT) investigated whether a 6-month telephone-based patient-centred program—RESPOND—had an effect on falls and fall injuries in older people presenting to the ED after a fall.
Methods and findings
Community-dwelling people aged 60–90 years presenting to the ED with a fall and planned for discharge home within 72 hours were recruited from two EDs in Australia. Participants were enrolled if they could walk without hands-on assistance, use a telephone, and were free of cognitive impairment (Mini-Mental State Examination > 23). Recruitment occurred between 1 April 2014 and 29 June 2015. Participants were randomised to receive either RESPOND (intervention) or usual care (control). RESPOND comprised (1) home-based risk assessment; (2) 6 months telephone-based education, coaching, goal setting, and support for evidence-based risk factor management; and (3) linkages to existing services. Primary outcomes were falls and fall injuries in the 12-month follow-up. Secondary outcomes included ED presentations, hospital admissions, fractures, death, falls risk, falls efficacy, and quality of life. Assessors blind to group allocation collected outcome data via postal calendars, telephone follow-up, and hospital records. There were 430 people in the primary outcome analysis—217 randomised to RESPOND and 213 to control. The mean age of participants was 73 years; 55% were female. Falls per person-year were 1.15 in the RESPOND group and 1.83 in the control (incidence rate ratio [IRR] 0.65 [95% CI 0.43–0.99]; P = 0.042). There was no significant difference in fall injuries (IRR 0.81 [0.51–1.29]; P = 0.374). The rate of fractures was significantly lower in the RESPOND group compared with the control (0.05 versus 0.12; IRR 0.37 [95% CI 0.15–0.91]; P = 0.03), but there were no significant differences in other secondary outcomes between groups: ED presentations, hospitalisations or falls risk, falls efficacy, and quality of life. There were two deaths in the RESPOND group and one in the control group. No adverse events or unintended harm were reported. Limitations of this study were the high number of dropouts (n = 93); possible underreporting of falls, fall injuries, and hospitalisations across both groups; and the relatively small number of fracture events.
In this study, providing a telephone-based, patient-centred falls prevention program reduced falls but not fall injuries, in older people presenting to the ED with a fall. Among secondary outcomes, only fractures reduced. Adopting patient-centred strategies into routine clinical practice for falls prevention could offer an opportunity to improve outcomes and reduce falls in patients attending the ED.
Australian New Zealand Clinical Trials Registry (ACTRN12614000336684).
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