Fall related disability and fall prevention among older adults: A community-based study in Pune city

Most of the falls in older adults are associated with one or more identifiable risk factors such as weakness, poor vision, unsteady gait and balance, confusion, certain medications and environmental risk factors such as slippery floor, uneven roads, poor lighting etc.Falls among older adults often leads to decreased independence, inability to perform daily activities, psychological stress, hospitalization and disability. Review of the literature shows that many strategies to reduce the risk of falls have already been implemented among the elderly. The majority of these intervention strategies used a variety of approaches including medication management, vision correction, home modification and exercise including strength training and, balance training. Though these strategies have shown to be effective at reducing falls, they have not been conducted among the community dwelling older adults in India. Thus, there is paucity of community-based intervention programme for fall prevention in India.  Evidence suggests that interventions targeting fall risk factors are effective. As falls in older adults are not recognized in India, it remains unknown whether, or to what extent, this body of evidence has been effective in Indian community dwelling older adults.

Therefore, the current quasi-experimental study aims to study the efficacy of a multifactorial intervention in the prevention of fall. The intervention will be divided into 4 quadrants: 1) Monitored exercise module 2) Home-based exercise module 3) Awareness-Education material 4) Counselling about home modification. The intervention will consist of monitored home based exercise program and online/tablet based exercise programme which will help in improving the balance and gait parameters. Balance and gait will be measured at the beginning of the study, and then measured again at the end of the intervention at 16 weeks and 20 weeks post intervention. The third and the fourth component will be addressed through providing educational material and counselling about home modification such as using grab bars, lights in the corridors, anti-slippery flooring etc. Knowledge regarding falls and home modification will be assessed before and after the intervention. This research would be helpful in creating sufficient evidence for recognizing fall in older adults as a public health issue and need to address it in the public health system.