Introduction/Rationale: Older adults receiving home-delivered meals experience falls at nearly twice the rate of the general aging population. Despite the known links between malnutrition, mobility impairments, and fall risk, fall prevention strategies for this population remain understudied. This pilot randomized controlled trial (RCT) examined whether integrating registered dietitian nutritionist (RDN) and occupational therapy (OT) services into home-delivered meal programs could reduce perceived fall risk among older adults.
Objectives: To determine the preliminary effects of RDN and OT services, in combination with home-delivered meals, on perceived fall risk in homebound older adults.
Methods/Approach: This four-arm pilot RCT recruited adults aged 60+ receiving home-delivered meals from a social service agency in the Midwest. Participants (N=56) with at least one fall risk factor and a self-reported diagnosis of diabetes or cardiovascular disease were randomized into one of four groups: (1) meals only, (2) meals + RDN, (3) meals + OT , or (4) meals + RDN + OT . Perceived fall risk was assessed using the Short Falls-Efficacy Scale-International (FES-I) at baseline and after 12 weeks. Repeated-measures, mixed-effects linear regression models evaluated changes across study arms.
Results/Practice implications: Of the 56 enrolled participants, 44 (79%) completed follow-up assessments. All intervention arms demonstrated statistically significant reductions in FES-I scores, with the greatest effect observed in the meals + RDN + OT group (mean difference = -6.01, p = 0.0014, d = -0.74).
Conclusion/Contribution to the occupational therapy profession: Findings suggest that combining OT and RDN services with home-delivered meals may reduce perceived fall risk in homebound older adults.