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Maintaining independence at home after a fall: a process evaluation of the MAINTAIN multicomponent intervention for people living with dementia
Leanne Greene, Louise M. Allan, Alison Bingham, Ashima K. Sharma, Bethany Whale, Robert Barber, Christopher Fox, Victoria A Goodwin et al.. Age and Ageing, 2025-08-29
Topic: Risk, prevention and care in population studies
The MAINTAIN intervention demonstrated high fidelity in home assessments and intervention delivery, with participants receiving a mean of 15 of the 22 available sessions with a range of 5-25 sessions. Qualitative findings revealed that regular home visits increased engagement and motivation. Multidisciplinary team support enhanced therapists' confidence, particularly with complex cases. While most participants achieved their functional goals and reported improved confidence, challenges included geographical disparities in service delivery, carer burden and varying effectiveness of referral pathways. Therapists' attitudes towards advanced dementia influenced intervention delivery. The paired approach, involving both the person living with dementia and their carer, supported activity engagement but occasionally added extra responsibilities for caregivers. MAINTAIN was both feasible and acceptable. Future studies should consider standardising multidisciplinary support, incorporating targeted falls-related anxiety support and establishing sustainable post-intervention maintenance strategies. Protocol adaptations, such as video consultations, showed promise in addressing workforce constraints.
Key findings
- The MAINTAIN intervention demonstrated high fidelity in home assessments and intervention delivery, with participants receiving a mean of 15 of the 22 available sessions with a range of 5-25 sessions.
- Qualitative findings revealed that regular home visits increased engagement and motivation.
- Multidisciplinary team support enhanced therapists' confidence, particularly with complex cases.
- While most participants achieved their functional goals and reported improved confidence, challenges included geographical disparities in service delivery, carer burden and varying effectiveness of referral pathways.
- Therapists' attitudes towards advanced dementia influenced intervention delivery.
Why it matters
This process evaluation found the MAINTAIN home-based intervention for people with dementia after a fall was feasible and acceptable, with most participants achieving functional goals and reporting improved confidence. It evaluates delivery of a falls intervention and does not test whether it treats, cures, or prevents Alzheimer's disease.
Study details
- Study designrandomized controlled trial
- Evidence strengthHigh
How this study scored 54/100
Published in a peer-reviewed journal, and it is a randomised controlled trial. Scored zero for sample size, effect reported and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Age and Ageing) |
| Journal's citation record | 2 / 4 | Age and Ageing: journal h-index 231 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 1 / 7 | Cited 2 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.7 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 4.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Sarah Morgan‐Trimmer: h-index 20 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Birmingham: institution h-index 1,266 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 10 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40928757) |
| Free to read | 2 / 2 | Free to read |
| Total | 54 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Greene, L., Allan, L. M., Bingham, A., Sharma, A. K., Whale, B., Barber, R., et al. (2025). Maintaining independence at home after a fall: a process evaluation of the MAINTAIN multicomponent intervention for people living with dementia. Age and Ageing. https://doi.org/10.1093/ageing/afaf245
Vancouver
Greene L, Allan LM, Bingham A, Sharma AK, Whale B, Barber R, et al. Maintaining independence at home after a fall: a process evaluation of the MAINTAIN multicomponent intervention for people living with dementia. Age and Ageing. 2025. doi:10.1093/ageing/afaf245. PMID: 40928757.
BibTeX
@article{greene2025-40928757,
author = {Greene, Leanne and Allan, Louise M. and Bingham, Alison and Sharma, Ashima K. and Whale, Bethany and Barber, Robert and Fox, Christopher and Goodwin, Victoria A and others},
title = {{Maintaining independence at home after a fall: a process evaluation of the MAINTAIN multicomponent intervention for people living with dementia}},
journal = {Age and Ageing},
year = {2025},
doi = {10.1093/ageing/afaf245},
pmid = {40928757},
url = {https://doi.org/10.1093/ageing/afaf245}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.