Preventing Falls in Older Adults with Technology

Falls in older adults are more than just a little trip- they're a major health issue. About one in three people aged 65 and older will experience a fall each year. If you're wondering about those who are over 80, the number jumps to one in two. For some, falls are not just a one-time event. Half of those who fall will do so again. The results can be serious. A fall can lead to hip fractures, which then make it hard to move around and maintain independence. It's estimated that treating these injuries costs around £4.4 billion each year. With so many falls and related problems, it's clear that we need effective ways to prevent them.

#What Causes Falls?

As we age, our bodies change. Many older adults experience lower cognitive abilities and decreased Mobility, both of which increase the chance of falling. Studies show that older adults who are more mobile tend to do better on tests of memory, processing speed, and overall thinking abilities. Also, as we age, multitasking becomes a bit more challenging. Research indicates that older adults who struggle to multitask are at a higher risk of falling.

There’s a promising solution called Dual-Task (DT) training, which involves doing two things at once-like walking while solving simple puzzles. Doing this type of training is shown to be more effective than just focusing on physical exercises alone. People who engage in DT training tend to walk faster and with more confidence.

#Technology to the Rescue

One exciting aspect of DT training is that it can be done through technology like mobile apps. These apps allow older adults to practice cognitive exercises while also doing physical movements. The good news is that these apps are interactive and offer instant feedback, making it easier for older adults to stay engaged and committed to their exercise routines. Earlier research showed that older adults participating in home-based DT training programs using mobile apps saw improvements in their walking speed and balance.

While the idea of using technology sounds great, not everyone finds it easy. Some older adults may feel overwhelmed or unsure about using mobile apps. To address this, a blended approach could be beneficial. This means mixing supervised sessions with those done at home. In this way, participants get hand-on guidance and can become more comfortable with the technology before trying it on their own.

#The Aim of the Study

This study focuses on how acceptable and practical a DT program using a mobile app is for older adults who have fallen multiple times recently. There are two main goals:

1. To see if older adults living in the community are willing to try a technology-based DT program.
2. To assess whether the program can be used by the National Health System to manage and prevent falls.

Additionally, the data collected from this study will be used to design a larger trial to see if this blended approach is effective in preventing falls.

#How the Study Works

#Study Design

This study will follow older adults with a history of falls for 24 weeks. There are two phases:

• Phase 1: Supervised DT training for 12 weeks.
• Phase 2: Self-directed training via the app for another 12 weeks.

Participants will be recruited from healthcare providers and community locations in Birmingham, UK. Various methods will promote this study, such as messages from doctors, posters in community centers, and information distributed in retirement homes.

#Who Can Join?

To join the study, participants must:

1. Be 65 years old or older.
2. Be able to understand instructions.
3. Stand with support for at least 60 seconds.
4. Get up from a chair and walk independently.
5. Use the toilet on their own.
6. Have access to a smartphone or tablet.
7. Have had two or more falls in the last year.

Those who cannot exercise due to serious health conditions or are part of another research study will not be able to participate.

#Sample Size

The study aims to recruit around 50 participants. This number is based on previous research, suggesting that between 50 to 100 participants is ideal for pilot studies. With 50 participants, researchers can estimate the drop-out rate and gather useful information for future studies.

#The Training Program

All participants will take part in the DT program for 24 weeks. Here's how it breaks down:

#Phase 1: Supervised Training

During the first 12 weeks, participants will join a weekly exercise class led by a physiotherapist. Each session will last for about 50 minutes and will include exercises targeting both strength and balance. Participants will also be doing cognitive tasks from the mobile app during these exercises.

#Phase 2: Home-Based Training

For the next 12 weeks, participants will engage in self-directed training. They will follow the exercises they learned in Phase 1 using the mobile app three times a week at home.

#What is Dual-Task Training?

DT training involves doing two tasks at the same time-like walking while using your brain. Participants will perform cognitive exercises from the mobile app concurrently with physical exercises. The app includes various games that challenge memory, attention, and thinking skills.

Each week during the exercise classes, participants will be guided on how to perform static and dynamic exercises. The physiotherapist will show them how to do the exercises safely and effectively. In addition, they will be provided with handbooks that detail the exercises and access to instructional videos.

#Self-Directed Exercise at Home

In Phase 1, when participants are not in class, they will continue practicing the exercises at home twice a week. In Phase 2, when they are fully self-directed, they will do exercises three times a week. This approach allows participants to become familiar with the exercises and the app, helping them to stay motivated.

Participants will keep track of their progress in an exercise diary, noting the games they played and the exercises they completed. They can also ask the research team for help if they have questions.

#Education Session

At the end of Phase 1, participants will attend a falls awareness session, reminding them about the upcoming self-directed phase. They’ll discuss ways to stay motivated, like creating chat groups or having coffee meet-ups with other participants.

#Assessing Feasibility

The study will gather information to determine if the program is appealing and practical. Key areas to assess include:

• Recruitment Rates: How many people agree to join the study?
• Adherence: Are participants sticking to the exercise plans?
• App Usage: Are they using the mobile app as intended?

#Collecting Data

Throughout the study, data will be collected at three different times: the start, after Phase 1, and after Phase 2. Information about participants, such as age and health background, will be collected to provide context for the study.

Several measures will be taken to assess the effects of the training, including:

1. Mobility and Balance: Using a simple test to measure how quickly and safely participants can get up, walk, and sit back down.
2. Cognitive Function: Using questionnaires to identify changes in cognitive abilities that may affect daily living.
3. Self-Efficacy: Assessing how confident participants feel about doing daily activities without the fear of falling.
4. Quality of Life: Evaluating whether participants feel their overall quality of life has improved.
5. Resource Use: Looking at how often they need to go to the doctor or use other healthcare services.
6. Number of Falls: Keeping track of any falls that occur during the study.

#Learning from Focus Groups

Once the program is completed, focus groups will be held with participants and healthcare professionals. These discussions will provide insights into the strengths and weaknesses of the program and how it can be improved.

#Analyzing the Results

The study analysis will focus on how well the program works and if older adults find it helpful. Feasibility outcomes will be presented as percentages, allowing researchers to see how well it’s received.

#Keeping Track of Data

All study records will be kept securely, both in printed form and digitally. A software called RedCap will be used to manage electronic records. All recordings from focus groups will be stored safely, ensuring that participant privacy is respected.

#Study Management and Safety

The training program is designed to be low-risk. Monthly meetings will ensure that everything runs smoothly and participants stay safe. Three community members will also provide feedback to help improve the study.

#Ethical Considerations

The study has been approved by relevant ethics boards. It’s expected to be completed by the end of 2025, and results will be shared with the public via conferences and medical journals.

#The Impact of Falls

Falls among older adults affect not just physical health but mental well-being too. They can create a fear of falling, which might lead to more falls. That's why addressing both physical and Cognitive Functions is crucial in preventing falls.

By studying the feasibility of this technology-based training program, researchers hope to pave the way for larger trials. This could not only help older adults but also lead to better practices in managing other health conditions as well.

#The Future is Bright

With the rising number of smartphone users among older adults, now is the perfect time to see how technology can help them stay safe and active. The study outcomes may help integrate digital tools into standard care, ensuring that older adults can benefit from innovative methods to prevent falls.

In summary, this study is not just about preventing falls; it’s about empowering older adults to maintain their independence and improve their quality of life. Now, if only we could find a way to make sure they don’t trip over their own feet while checking their messages!