Falls Prevention Programs are Helping the Aging Population Overcome Physical and Emotional Barriers to Well-Being in an Easy and Effective Way

The following is a guest article by Dr. Byron Crowe, M.D., Chief Medical Officer at Solera Health.

For millions of older adults each year, even a small mishap such as tripping over a rug or sliding on a damp floor can have far-reaching consequences when it results in a fall. As individuals get older, reductions in strength and balance increase the risk of an unexpected fall, with substantial implications for individuals and population health. 

The Burden of Falls on Older Adults

Between 2010 and 2020, the U.S. population of those 65 and older grew by more than a third. And by 2030, those older than the age of 65 will make up more than 20% of the population. Every year, about one in four of these older adults experience a fall, accounting for 36 million falls annually. As the general population grows and stays older in the coming years, the number of annual falls is expected to increase. Concerningly, one of every five falls results in an injury, leading to approximately 800,000 hospitalizations, 300,000 debilitating hip fractures and 32,000 deaths annually. 

Substantial evidence from clinical trials supports the use of exercise to prevent falls, and in particular exercises that promote strength building and which challenge balance. Current evidence suggests that these interventions reduce the risk of falling by 21% or more. When applied to the older adult population, such a reduction in fall risk would prevent millions of falls annually, leading to far fewer injuries and deaths. Reducing the number of falls and injuries from falls would also lead to substantial economic benefits given that total medical costs related to falls exceed $50 billion annually.

The Intersection of Falls and Mental Health in the Elderly

Although physical injuries may be the most obvious effect of falls, the mental health impact is substantial and often under-recognized. Deficits in strength and balance can lead to a fear of falling in older adults, and this fear leads to subsequent reductions in physical activity that can contribute to social isolation and loneliness. Studies typically show that 25-50% of community-dwelling older adults experience fear of falling, with symptoms often persisting for years. Likewise, falls and depression often go hand in hand, leading to a complex interplay between these two factors that ultimately leads to increased risk for both conditions – a fall can lead to the onset of depression, while depression can increase the likelihood of a debilitating fall. When considering the total benefits of fall prevention programs, it is critical to include mental health improvements as a key outcome in addition to injury prevention.

The Role of In-Person and Digital Programs for Fall Prevention

Given the substantial physical and mental health burden of falls, researchers have created and studied diverse programs that seek to reduce fall risk. Historically, these fall prevention programs have only been available in-person, often in a group format, but a new crop of digital programming for older adults has the potential to expand access to beneficial programs. Current recommendations from the USPSTF support a variety of exercise interventions to reduce fall risk, and exercise performed at home through a digital modality can be effective while reducing barriers to access from in-person requirements.

For example, one provider of digital balance training, Nymbl, found that 93% of older adults felt it was important to have access to balance training programs in their own home, and users of the program significantly improved objective measures of balance that suggest decreased fall risk. Other digital interventions like the Bold program have found similar success increasing beneficial physical activity, with a cohort of participants in one study doubling weekly physical activity and decreasing annualized risk of falling by 46%. In-person exercise programs remain a viable option for those who prefer it, but digital programs are creating new pathways to achieve evidence-based physical activity and balance training at scale. 

Adding Falls Prevention to the Digital Health Toolkit

As digital health programs continue to permeate the healthcare landscape, digital falls prevention programs are poised to become an important tool for practitioners to improve the physical and mental health of older adults. A growing evidence base suggests that such solutions are able to achieve improvements in balance and reductions in falls similar to in-person programs, while an increasingly tech-enabled generation of older adults finds such solutions both acceptable and desirable. When paired with a digital front door that facilitates easy access to a full suite of digital health programs, digital falls prevention programs can sit alongside a growing list of easily accessible and convenient health tools. Ultimately, by expanding the reach of these programs and increasing the activity of older adults, these solutions can address an important contributor to elderly falls while improving physical and mental health at a population level.

About Byron Crowe

Dr. Crowe is the Chief Medical Officer for Solera Health. In his role, he oversees clinical program design for digital and community health solutions offered on the Solera platform that address the most pressing physical, mental and social health needs of populations.

   

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