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A randomized trial of a multicomponent home intervention to reduce functional difficulties in older adults
Center for Applied Research on Aging and Health Research Papers
  • Laura N. Gitlin, Thomas Jefferson University
  • Laraine Winter, Thomas Jefferson University
  • Marie P. Dennis, Thomas Jefferson University
  • Mary Corcoran, George Washington University
  • Walter W. Hauck, Thomas Jefferson University
Document Type
Publication Date
This article has been peer reviewed. It is the authors' final version prior to publication in Journal of the American Geriatrics Society 54(5):809-816, May 2006. The published version is available at

OBJECTIVES: To test the efficacy of a multicomponent intervention to reduce functional difficulties, fear of falling, and home hazards and enhance self-efficacy and adaptive coping in older adults with chronic conditions.

DESIGN: A prospective, two-group, randomized trial. Participants were randomized to a treatment group or no-treatment group.

SETTING: Urban community-living older people.

PARTICIPANTS: Three hundred nineteen community-living adults aged 70 and older who reported difficulty with one or more activities of daily living.

INTERVENTION: Occupational and physical therapy sessions involving home modifications and training in their use; instruction in strategies of problem-solving, energy conservation, safe performance, and fall recovery techniques; and balance and muscle strength training.

MEASUREMENTS: Outcome measures included self-rated functional difficulties with ambulation, instrumental activities of daily living, activities of daily living, fear of falling, confidence performing daily tasks, and use of adaptive strategies. Observations of home hazards were also conducted.

RESULTS: At 6 months, intervention participants had less difficulty than controls with instrumental activities of daily living (P = .04, 95% confidence interval (CI) = -0.28 – 0.00) and activities of daily living (P = .03, 95% CI = -0.24 to -0.01), with largest reductions in bathing (P = .02, 95% CI = -0.52 to -0.06) and toileting (P = .049, 95% CI = -0.35 – 0.00). They also had greater self-efficacy (P =.03, 95% CI = 0.02 – 0.27), less fear of falling (P = .001, 95% CI = 0.26 – 0.96), fewer home hazards (P = .05, 95% CI = -3.06 – 0.00), and greater use of adaptive strategies (P = .009, 95% CI = 0.03 – 0.22). Benefits were sustained at 12 months for most outcomes.

CONCLUSION: A multicomponent intervention targeting modifiable environmental and behavioral factors results in life quality improvements in community-dwelling older people who had functional difficulties, with most benefits retained over a year.

Citation Information
Laura N. Gitlin, Laraine Winter, Marie P. Dennis, Mary Corcoran, et al.. "A randomized trial of a multicomponent home intervention to reduce functional difficulties in older adults" (2006)
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