Abstract
Background: 29% of older adults fall annually, resulting in the leading cause of accidental death. Fall prevention programs typically include exercise training and self-monitoring of physical activity has a positive effect on the self-efficacy and self-regulation of exercise behaviors. We assessed if self-monitoring of fall risk, without an intervention, impacts fall rates.Methods: Fifty-three older adults had open access to a balance measuring platform which allowed them to self-monitor their postural stability and fall risk using a simple 1-min standing balance test. 12-month retrospective fall history was collected and a monthly/bimonthly fall log captured prospective falls. Participants had access to self-monitoring for up to 2.2 years. Fall history and fall incidence rate ratios and their confidence intervals were compared between the periods of time with and without access to self-monitoring.Results: A 54% reduction in the number of people who fell and a 74% reduction in the number of falls was observed when participants were able to self-monitor their postural stability and fall risk, after normalizing for participation length. Further, 42.9% of individuals identified as having high fall risk at baseline shifted to a lower risk category at a median 34 days and voluntarily measured themselves for a longer period of time.Discussion: We attribute this reduction in falls to changes in health behaviors achieved through empowerment from improved self-efficacy and self-regulation. Providing older adults with the ability to self-monitor their postural stability and intuit their risk of falling appears to have modified their health behaviors to successfully reduce fall rates.
Highlights
Each year, 28.7% of older adults fall in the US resulting in 300,000 hip fractures, over $50 billion dollars in medical costs (Florence et al, 2018), and is the leading cause of accidental death in this population (Gillespie et al, 2012)
We provided residents at a senior living facility and older adults who regularly visit a community center for seniors access to easy-to-use technology which measures postural stability as an indicator of fall risk and tracked them longitudinally to determine if self-monitoring influenced their rate of falls
We propose that the empowering effect of self-monitoring fall risk and instability could have been especially potent because older adults may have been educated on the benefits of exercise and fall prevention, but they often have limited knowledge and understanding about their own fall risk/balance state
Summary
28.7% of older adults fall in the US resulting in 300,000 hip fractures, over $50 billion dollars in medical costs (Florence et al, 2018), and is the leading cause of accidental death in this population (Gillespie et al, 2012). Less than half of the older adult population exercise sufficiently for general health benefits, and that number is further reduced for those aged 75 and older (Schoenborn et al, 2013). This deficiency of physical activity in older adults presents a clear opportunity for reducing the likelihood of falling. Interventions focused on changing exercise health behaviors may provide an opportunity for changing health behaviors beneficial to fall preventing a fall, such as increasing one’s awareness of balance health and fall risk
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