Could Community-based Screenings Help Prevent Falls Among the Elderly?

A recent study found that community-level interventions could result in short- and long-term changes in behavior to reduce fall risk among older adults.

“Falls are the leading cause of morbidity and mortality among [U.S.] older adults and result in considerable medical and social consequences,” the study authors wrote. “Community-based screenings are a type of intervention that provides accessible fall risk screening and education at no cost to the participants.” However, whether such interventions have lasting effects on behavior was unclear, which prompted the researchers to undertake the study.

The researchers recruited patients during 22 community-based, physical therapist-led fall risk screening events, which used a modified version of the Centers for Disease Control and Prevention Stopping Elderly Accidents, Deaths, and Injuries (CDC STEADI) toolkit to screen patients. Baseline demographic and screening results were collected, and screening results were also obtained at one- and five-month follow-up to evaluate behavioral changes.

Research from the University of Vermont suggests that free community-based events are effective in educating and establishing fall risk reduction strategies among older adults. #ABA #healthbehavior https://t.co/jI8GcsaA79

— Behavior Science News (@BehaviorNews) March 20, 2019

A Little Bit Goes a Long Way

A total of 104 patients were available for one- and five-month follow-up. After one month, half of patients had adopted at least one fall risk-reducing behavior; by five months, 64.9% of patients had done so. Patients with moderate or high fall risk were significantly more likely to adopt a new behavior change compared to patients who had a low fall risk (P = 0.04). In an age- and sex-adjusted model, the odds ratio (OR) of adopting a new fall risk-reducing behavior was increased among patients with higher education (OR: 2.5, 95% confidence interval [CI]: 1.0–6.0) and moderate/high fall risk (OR: 3.0, 95% CI: 1.3–7.2).

“The big thing that we are excited about is that most of the older adults who participated in these community-based screenings did adopt a fall risk reduction strategy afterward,” said study author Lee Karlsson, MScPH, an epidemiologist and UVM doctor pf physical therapy student, in a press release. “That shows the value of these low-cost community-based screenings to foster evidence-based behavior changes.”

Fall risk changes overtime and increases with age, which is why periodic screenings are important, according to study author Nancy Gell, PT, PhD, MPH.

“We were excited to see these single, one-time events did lead people to make changes. We were also pleased to see that 45 percent of the participants had shared their screening results, which is helpful and easier for a primary care provider to follow up and make further recommendations,” said Dr. Gell.

The authors wrote in their abstract, “Screening and education using the STEADI toolkit during community-based screenings result in short- and long-term behavior change to reduce fall risk among older adults, particularly those with moderate to high fall risk. Further research is needed to identify barriers and incentives among participants who do not make fall-related behavioral changes after screening.”