Citation

Vind AB, Andersen HE, Pedersen KD, Jørgensen T, Schwarz P. J. Am. Geriatr. Soc. 2009; 57(10): 1844-1849.

Copyright

(Copyright © 2009, John Wiley and Sons)

DOI

10.1111/j.1532-5415.2009.02435.x

PMID

unavailable

Abstract

OBJECTIVES: To address the external validity of a trial of multifactorial fall prevention through an analysis of differences between participants and nonparticipants regarding socioeconomic and morbidity variables.

DESIGN: Analysis of nonresponse in a randomized clinical trial.

SETTING: Geriatric outpatient department.

PARTICIPANTS: One thousand one hundred five community‐dwelling adults aged 65 and older who had sustained at least one injurious fall.

MEASUREMENTS: Marital status, housing tenure, income, comorbidity, hospitalization, fractures, and drug use before invitation to participate in the trial. Fractures, hospitalization and death were measured for 6 months of follow‐up.

RESULTS: Four hundred forty‐seven responding nonparticipants and 266 nonresponding nonparticipants were compared with 392 participants in the trial. Lower income (odds ratio (OR)=2.38, 95% confidence interval (CI)=1.28–4.28) and more days of hospitalization during the previous 5 years (OR=1.96, 95% CI=1.15–3.33) predicted responding nonparticipation; independent predictors of being a nonresponding nonparticipant were unmarried status (OR=2.0, 95% CI=1.36–2.94), lower income (OR=4.74, 95% CI=2.30–9.78), more days of hospitalization (OR=3.49, 95% CI=1.99–6.11), and prior fractures (OR=1.56, 95% CI=1.02–2.38). Nonresponding nonparticipants were significantly more likely to die (OR=12.99, 95% CI=1.6–105.6) or be hospitalized (OR=2.66, 95% CI=1.7–4.1) than participants during 6 months of follow‐up.

CONCLUSION: Nonresponding nonparticipants of a trial of multifactorial fall prevention differed significantly from participants in terms of socioeconomic and morbidity variables and were more likely to be hospitalized or die during 6 months of follow‐up. Because of the differences between the two populations, it is questionable whether results from this randomized trial can be generalized to people potentially eligible for participation.