Fear of falling has serious consequences for older people. Interventions that successfully reduce fear of falling and improve fall-related self-efficacy are likely to have major health benefits.

Home visits by occupational therapists can prevent falls among older people who are at increased risk of falling. However, the effect may not be caused by home modifications alone. Home visits by occupational therapists may also lead to changes in behavior that enable older people to live more safely in both the home and the external environment.

Use of the keyword mnemonic has been shown to substantially increase learning speed and immediate recall of 2nd-language vocabulary words in comparison with other learning strategies. Although the majority of researchers examining long-term retention of material acquired through the keyword method have concluded that these gains are maintained over time, most have relied on experimental designs based on within-subject comparisons. However, within-subject comparisons of retention over time are confounded by both rates of initial acquisition and level of immediate recall. In this article data are presented from 4 experiments in which the retention interval (immediate vs. delay) was treated as a between-subjects factor. The findings consistently indicated that long-term forgetting was greater for learners instructed to use the keyword mnemonic than for learners engaged in rote rehearsal. It is suggested that preexperimental associations to keywords interfere with retrieval of the interactive images established in the laboratory.

A major barrier to adherence to home modification recommendations is that many older people do not believe that home modifications can reduce their risk of falling.

BACKGROUND: The effectiveness of individual components (other than exercise) of multifactorial intervention packages aimed to reduce the incidence of falls in older people is uncertain. There have been no randomised trials of home modifications alone for the prevention of falls. OBJECTIVES: To estimate the cost–effectiveness of just one component of a multifactorial approach to falls prevention, that is, a home hazard reduction program. The study estimates the size and direction of change in resource use within and between the hospital, home and community sectors. METHODS: A randomised trial was conducted to evaluate the effectiveness of home modifications for prevention of falls among older people. An occupational therapist (O/T) with experience in aged care assessed homes for environmental hazards and supervised the necessary home modifications. SUBJECTS: The subjects in this study were people aged 65 years and older and most were recruited during a hospital stay. The cost–effectiveness analysis was based on a randomised trial with a total of 530 subjects. RESULTS: The incremental cost per fall prevented was $4,986. A sensitivity analysis was conducted by removing 12 outlier subjects (6 control and 6 intervention). The incremental cost per fall prevented was $1,921 for all subjects and was cost saving for subjects who had fallen in the 12 months prior to randomisation. CONCLUSIONS & IMPLICATIONS: A single factor home hazard reduction program is more likely to be most cost–effective amongst older people who have a history of falls.