A Digital Health Fall Prevention Program for Older Adults: Feasibility Study

Abstract

Background About 1 in 3 adults aged 65 and older falls annually. Exercise interventions are effective in reducing the fall risk and fall rate among older adults. In 2020, startup company Age Bold Inc. disseminated the Bold Fall Prevention Program, aiming to reduce falls among older adults through a remotely delivered, digital exercise program. Objective We conducted a feasibility study to assess the delivery of the Bold Fall Prevention Program remotely and evaluate the program's impact on 2 primary outcomes—annualized fall rate and weekly minutes of physical activity (PA)—over 6 months of follow-up. Methods Older adults at high risk of falling were screened and recruited for the feasibility study via nationwide digital advertising strategies. Self-reported outcomes were collected via surveys administered at the time of enrollment and after 3 and 6 months. Responses were used to calculate changes in the annualized fall rate and minutes of PA per week. Results The remote delivery of a progressive digital fall prevention program and associated research study, including remote recruitment, enrollment, and data collection, was deemed feasible. Participants successfully engaged at home with on-demand video exercise classes, self-assessments, and online surveys. We enrolled 65 participants, of whom 48 (74%) were women, and the average participant age was 72.6 years. Of the 65 participants, 54 (83%) took at least 1 exercise class, 40 (62%) responded to at least 1 follow-up survey at either 3 or 6 months, 20 (31%) responded to both follow-up surveys, and 25 (39%) were lost to follow-up. Among all participants who completed at least 1 follow-up survey, weekly minutes of PA increased by 182% (ratio change=2.82, 95% CI 1.26-6.37, n=35) from baseline and annualized falls per year decreased by 46% (incidence rate ratio [IRR]=0.54, 95% CI 0.32-0.90, n=40). Among only 6-month survey responders (n=31, 48%), weekly minutes of PA increased by 206% (ratio change=3.06, 95% CI 1.43-6.55) from baseline to 6 months (n=30, 46%) and the annualized fall rate decreased by 28% (IRR=0.72, 95% CI 0.42-1.23) from baseline to 6 months. Conclusions The Bold Fall Prevention Program provides a feasible strategy to increase PA and reduce the burden of falls among older adults.

“I wouldn’t have joined if it wasn’t online”: understanding older people’s engagement with teleyoga classes for fall prevention

“…Teleyoga has been used with diverse populations to tackle various health conditions and has been found to be acceptable, with good adherence and positive health outcomes [ 28 – 32 ], equalling responses to in-person yoga programs [ 33 ]. Similarly, online fall prevention programs have been found to be feasible and acceptable to older participants [ 34 , 35 ], supporting the premise of a teleyoga program designed to prevent falls. Although there is currently limited evidence about the effects of online exercise programs that offer synchronous (real time) versus asynchronous (pre-recorded) classes [ 36 , 37 ], some studies suggest that synchronous programs are more engaging with higher levels of adherence and physical activity [ 38 – 40 ].…”

Neuromotor Exercise Training

“…The Centers for Disease Control and Prevention reported that more than one out of four seniors fall each year, and one out of five falls causes serious injury (5). A fall has been defined as an unexpected event where the participant meets the ground, floor, or lower level (6). Most falls take place in the home due to loss of balance, dizziness, tripping, or slipping (7).…”

“…However, the Bold Fall Prevention Program explored the effect of a digital fall prevention program for older adults, which is delivered remotely with an online, on-demand, exercise program (6). The progressive classes focused on physical strength, balance, and mobility through static and dynamic movements (6). Postclass follow-up with the instructors and research team was encouraged if participants had questions or needed additional guidance.…”

“…The worsening of balance, reaction time, and muscle strength are related to the increased risk of falls and disability. Exercising is one of the most effective ways to reduce fall risks because exercise can improve mobility, strength, and balance (6). Without attempting to provide a comprehensive review, a few select studies will be discussed.…”

“…Most programs focusing on fall prevention are offered in person. However, the Bold Fall Prevention Program explored the effect of a digital fall prevention program for older adults, which is delivered remotely with an online, on-demand, exercise program (6). The progressive classes focused on physical strength, balance, and mobility through static and dynamic movements (6).…”