Impact of COVID-19 Stay-At-Home Restrictions on Falls in One Community of High-Risk Older Adults

Abstract

Aim: To examine the relationship between falls among high-risk older adults at one Program of All-Inclusive Care for the Elderly (PACE) and the COVID-19 closure of its Day Health Center (DHC), which provides participants with social and rehabilitative services and contributes to their weekly physical activity. Methods: Self-reported falls during the 3 months before the DHC’s closure (“pre–COVID-19”) were compared in number and in character to falls during its closure (“COVID-19”). Results: One thirty five participants were enrolled during the entire 6-month period; 37% ( n = 50) fell during this time. These participants experienced fewer falls during COVID-19 (mean = 0.64) than they did pre–COVID-19 (mean=1.24, p = .0003). Conclusions: In this population of high-risk, community-dwelling older adults, an abrupt reduction in activity levels may have reduced falls. Physical activity has been shown to both increase and protect against falls in older adults. The long-term consequences of a comparably prolonged period of inactivity merit further study.

“I Can’t Take Any Chances”: A Mixed Methods Study of Frailty, Isolation, Worry, and Loneliness Among Aging Adults During the COVID-19 Pandemic

“…In the context of the ongoing COVID-19 pandemic, older adults are at risk of experiencing a chronic array of stressors that could accelerate frailty, including malnutrition, delaying routine medical care, drastic reduction in meaningful social interaction, and limited opportunity for exercise ( Boreskie et al, 2020 ; Czeisler et al, 2020 ; Steinman et al, 2020 ). The long-term consequences of COVID-19—related decline in physical activity—such as deconditioning and falls—has been raised as an area of particular concern ( McIntyre et al, 2022 ).…”

Evaluation of Geriatric Falls in Emergency Department During the Early Coronavirus-2019 Pandemic and Pre-Pandemic Periods

“…Results of presentations with falls to the ED are diverse reporting higher [12] or lower numbers during the pandemic period [13][14][15][16]. In our study, we showed that the number of geriatric fall presentations to ED, comorbidity burden, consultations, and LOS at the ED in those patients was lower, but direct costs were higher in the pandemic period than pre-pandemic period.…”

“…The risk of falls was predicted to increase in older individuals because of the negative effects of the COVID-19 pandemic [7,10,24,25]. However, presentations with falls have decreased during the pandemic period in the studies carried out in EDs and other settings [13][14][15][16][27][28][29]. It is considered that approximately half of all falls occur outside the home [30], and in Turkey, there were strict stay-at-home restrictions for older adults at the beginning of the pandemic.…”

“…Besides, negative mental, physical, and emotional effects have been shown on older people staying at home because of COVID-19 [10,11]. Results of studies on presentations with falls to the emergency department (ED) are diverse reporting higher [12] or lower rates during the pandemic period [13][14][15][16]. However, to the best of our knowledge, no research has been found to examine fall related injury types and regions, triage classi cation, consciousness levels, comorbidities-consultations as well as length of stay (LOS) in hospital/ ED, outcomes, and costs for older individuals during the pandemic, and compare to the prior pre-pandemic status.…”

Effectiveness of telerehabilitation and home-based falls prevention programs for community-dwelling older adults: a systematic review and meta-analysis protocol

“…In turn, there were increased fears associated with falling and loss of mobility 10 13. Longitudinal studies have reported that while the rates of falls were initially lower compared with the prepandemic era,14 15 falls and orthopaedic injuries subsequently increased when restrictions were lifted,16 17 potentially reflecting the deconditioning and impaired balance that accrued with sedentarism 10…”