Preventing falls and improving mobility in older adults
Falls are a big problem for older adults, one in three older adults will fall each year often leaving them fearful of falling and lacking confidence to walk and be active which is vital for independence.
One of the most effective ways to prevent falls and mobility decline is strength and balance training.
This work package will evaluate ways to deliver effective strength and balance training and increase our understanding of what puts an older person at risk of mobility decline and falling.
Part of our Improving Health and Social Care research theme
One of the biggest research priorities in modern healthcare is our aging population. What is needed to support older people to maintain good health and quality of life?
Fall related injuries, such as fractures, can have a severe impact on quality of life for older adults by impairing mobility, and they have yearly NHS costs of £2.3 billion. Public Health England has identified the prevention of falls and falls related fractures in older adults as one of their priority areas.
Muscle strength and balance training are an effective way to combat age and inactivity related decline in muscle strength and balance which can reduce falls in older adults. However, we know that only a small proportion of older adults are participating in these activities (less than 15% of the population over the age of 65). Increasing the participation of older adults in strength and balance training before they have a fall is vital.
This research programme will involve designing studies and applying for funding to test interventions focusing on strength, balance and mobility training for older adults.
We will also be using data from 5000 older adults enrolled in the Oxford, Pain, Activity and Lifestyle (OPAL) cohort study to understand when older people are at risk of mobility decline and falling. Adults enrolled in the OPAL group are also helping us to study the impact of COVID-19 on older people’s physical and mental health.
How we are involving patients and the public
A PPI group of older people has been formed to support this work on preventing falls and mobility decline in older adults.
This group has informed the research at the earliest stage by having a meaningful impact on potential studies before they are funded. Some members of the group are involved as co-applicants, alongside the researchers, on the funding applications.
PPI representatives from this group are also members of the wider stakeholder group, which helps to shapes this work package.
How we are planning to implement the research outputs
We have formed relationships with key partners including social prescribing networks, physiotherapy clinicians and primary care practices. Social Prescribing within primary care is a relatively new initiative that involves referral by the primary care team to a link worker who makes use of a local voluntary and community organisation or statutory sector. Older adults make up a substantial part of their caseload.
Social prescribers are ideally placed to identify older adults that would benefit from strength and balance training and refer and support older adults to attend training sessions.
We have met with several social prescribing team leads and social prescribers (also called link workers) to discuss study proposals and get advice on putting the findings into action.
The Chartered Society of Physiotherapy (CSP) has highlighted the role of physiotherapists in promoting strengthening exercises to their patients. We plan to continue to work with these organisations both to develop research projects but also to implement findings.
Deputy Director, Centre for Rehabilitation Research in Oxford
- To develop and evaluate ways to deliver effective strength, mobility and balance training for older adults and increase our understanding of what puts an older person at risk of mobility decline and falling.
To gain research funding to develop and test interventions that focus on increasing muscle strength, balance and walking ability in older adults.
To develop a screening tool for identifying older adults at risk of mobility decline and falls.
To understand the impact that COVID-19 has had on older people, particularly the impact on mobility decline and the risk of falls.
- We will produce a screening tool for use in primary care to identify when older adults are at risk of mobility decline.
- This will allow clinicians to identify when additional support or intervention should be provided for patients in order to help them maintain their mobility which is vital for independence.
- We expect to submit this work for publication by the end of 2021.
- Ongoing analysis of the OPAL cohort over the next year will help us to further understand when older people are at risk of falls and mobility decline including the impact of the COVID-19 pandemic and to understand how pain and comorbidities may influence these factors.
- In the longer term, we plan to develop effective interventions that help older people to maintain their mobility, prevent falls and improve their quality of life with potential cost savings related to reducing the need for health and social care.