Abstract
BACKGROUND: Falls in the older people with possible mild cognitive impairment are considered a public health problem and their consequences bring physical, psychological and financial losses. OBJECTIVE: To verify the effectiveness of an intervention based on case management on motor and environmental risk factors for falls in community-dwelling faller older people with possible mild cognitive impairment. DESIGN: This is a randomized clinical trial. SETTING: The study developed in the years 2021 and 2022. PARTICIPANTS: Participants were faller older people with cognitive deficits. The participants were divided into two groups: Control Group (CG) and Intervention Group (IG). INTERVENTIONS: The IG underwent case management for 16 weeks conducted remotely, which involved a multidimensional assessment, explanation of the identified risk factors for falls, completion of intervention proposal based on the identified risks. MAIN OUTCOME MEASURES: There were an initial assessment, a final assessment after 16 weeks, and a follow-up assessment after 6 weeks, remotely. The Short Physical Performance Battery (SPPB), Timed up and Go test (TUG) and TUG dual task, Manchester Index, Home Falls and Accidents Screening Tool (HOME FAST) were used, as well as foot inspection and shoe questionnaire. RESULTS: The total sample consisted of 52 older people, 25 from the CG and 27 from the IG. There was no significant interaction between groups and moments. The CG presented a worse performance in muscle strength when compared to the IG, regardless of the assessment. In feet and footwear, there was a significant difference between groups (CG and IG) in the initial assessment and between assessments in both CG and IG. CONCLUSION: There was no effectiveness of an intervention based on case management on the motor risk factors for falls in faller older people with possible mild cognitive impairment. However, regarding environmental risk factors, specifically the use of footwear, it was possible to verify changes regarding the use after the intervention and follow-up, with adherence to the recommendations given.