Improving Vision To Prevent Falls: A Randomized Trial
Funder
National Health and Medical Research Council
Funding Amount
$403,892.00
Summary
More than 30% of older Australians fall over at least once a year. Poor eyesight, another very common problem among older Australians, increases the risk of falling. In fact, recent evidence from the Blue Mountains Eye Study suggests that poor vision is one of the strongest risk factors for falls and fractures yet identied. Our project is designed to assess whether improving vision will decrease the chance of falls and fractures. We will recruit 1200 people aged 75 years and over from among thos ....More than 30% of older Australians fall over at least once a year. Poor eyesight, another very common problem among older Australians, increases the risk of falling. In fact, recent evidence from the Blue Mountains Eye Study suggests that poor vision is one of the strongest risk factors for falls and fractures yet identied. Our project is designed to assess whether improving vision will decrease the chance of falls and fractures. We will recruit 1200 people aged 75 years and over from among those attending community-based aged care services in the inner western suburbs of Sydney. If they consent to participate, people will be randomly allocated to either an intervention or control group. Those in the intervention group will receive a simple, yet comprehensive, series of vision and eye tests. These tests will be done by an optometrist, either in subjects' homes or at the study centre. Our previous research suggests that nearly 50% of subjects will benefit from having new glasses and 10% might require cataract surgery. If necessary, treatment will be paid for from study funds. Some vision problems cannot be fixed. In these cases, an occupational therapist will arrange appropriate home modifications to improve vision-related function. Subjects will be followed-up for 12 months to assess the frequency of falls in the intervention and control groups. We hope to find a 33% reduction in falls in the intervention group. We will follow subjects for a further year to identify fractures.Read moreRead less
Understanding Fear Of Falling And Risk Taking In Older People
Funder
National Health and Medical Research Council
Funding Amount
$355,877.00
Summary
Fear of falling is a very significant issue for many older people. Estimates of the prevalence of fear of falling in older community-dwelling people range from 29 to 92% in those who have suffered previous falls, and 12 to 65% in those have not. Fear of falling can lead to restriction and curtailment of activity, reduced quality of life, anxiety, depression and social isolation. To date, all studies addressing fear of falling have simply considered no fear to be good and presence of fear to be b ....Fear of falling is a very significant issue for many older people. Estimates of the prevalence of fear of falling in older community-dwelling people range from 29 to 92% in those who have suffered previous falls, and 12 to 65% in those have not. Fear of falling can lead to restriction and curtailment of activity, reduced quality of life, anxiety, depression and social isolation. To date, all studies addressing fear of falling have simply considered no fear to be good and presence of fear to be bad, and have not attempted to assess whether this fear is rational or irrational in relation to actual balance abilities or physical functioning. In this study, we aim to find out which psychological, physical, health and lifestyle factors distinguish between older people with and without an irrational fear of falling based on their actual physical falling risk. We also wish to understand the role that fear of falling and other psychological factors (anxiety, depression and avoidance) play in causing older people to fall; and to measure how falls can lead to increased fear of falling, anxiety and depression and reduced physical functioning. The complex nature of psychological risk factors of falling and the limited background information on this subject, hampers its integration in falls prevention programs. Although there is growing awareness of this problem among health care providers, additional research is needed about why older people develop a fear of falling in order to fully understand fear of falling and to tailor specific intervention and prevention strategies.Read moreRead less
Lifestyle (LIFE) Versus Structured Balance And Strength Training To Reduce Falls In The Elderly: A Randomized Trial
Funder
National Health and Medical Research Council
Funding Amount
$650,968.00
Summary
Thirty to thirty five percent of persons who are 70 or older fall each year. The magnitude of problems as a result of falling is reflected by the fact that the costs of fall injuries of the elderly to the health system is already more than double that of road injury. It is estimated that these costs will rise substantially and alarmingly in the next 30 to 50 years if we cannot find effective and sustainable ways to make an impact on the incidence of falls in older people. The aim of this project ....Thirty to thirty five percent of persons who are 70 or older fall each year. The magnitude of problems as a result of falling is reflected by the fact that the costs of fall injuries of the elderly to the health system is already more than double that of road injury. It is estimated that these costs will rise substantially and alarmingly in the next 30 to 50 years if we cannot find effective and sustainable ways to make an impact on the incidence of falls in older people. The aim of this project is to improve the capacity of people living at home to avoid falls. The project will evaluate the effectiveness of an integrated lifestyle approach to balance and strength exercise (LIFE) and a structured balance and strength exercise program to reducing falls in people who are at high risk . The control group will comprise a gentle flexibility exercise program as this is known to have no effect on reducing falls. In the lifestyle approach (LIFE), older people will be taught how to do balance and strength training and integrate it into their lifestyle so that it is embedded within their daily activity and weekly routines. It is expected that this integrated lifestyle approach to balance and strength training will be effective in reducing falls and will be sustainable over a a one-year period. This study will also determine for which groups of people LIFE is most effective . The research is a three-arm randomized trial that will be conducted with 381 people who are 70 years or over, who have experienced at least two falls in the past year or had an injurious fall. The notion of balance training is not well understood by allied health professionals or older people - a product of this project will be an alternative balance and strength intervention (LIFE) that offers, in a user friendly and simplified manner, a way of operationalizing the principles of balance and strength training for use by older people within their daily lives.Read moreRead less
Exercise Self-management To Improve Long-term Functioning And Prevent Falls After Hip Fracture.
Funder
National Health and Medical Research Council
Funding Amount
$848,478.00
Summary
Up to 20,000 older Australians suffer hip fractures each year. Many people don't fully recover. We have designed a self-management training program which incorporates individualised exercise prescription. This novel program is designed for people who have completed usual treatment and rehabilitation for hip fracture. We will conduct a well-designed randomised controlled trial to test the effects of this program on disability, falls and hospital readmissions and to assess its cost-effectiveness.
A Randomised Controlled Falls Prevention Trial Of Long Distance Glasses In Elderly Multifocal Wearers
Funder
National Health and Medical Research Council
Funding Amount
$493,000.00
Summary
Each year, one-third to a half of people over 65 years old will fall at least once. The consequences of falls are immense in terms of suffering, loss of independence, fear of future falls, carer burden, mortality, residential care admissions and other health care resource usage. Clearly, effective and affordable falls prevention strategies are needed to address this major health care problem. Over 50% of people over 65 years old use bi-, tri- or multi-focal glasses. The lower part of these glass ....Each year, one-third to a half of people over 65 years old will fall at least once. The consequences of falls are immense in terms of suffering, loss of independence, fear of future falls, carer burden, mortality, residential care admissions and other health care resource usage. Clearly, effective and affordable falls prevention strategies are needed to address this major health care problem. Over 50% of people over 65 years old use bi-, tri- or multi-focal glasses. The lower part of these glasses are useful for reading and seeing at close range only and there is now evidence that the use of these glasses is associated with an increased risk of falls due to the blurring of vision when looking through the lower lenses at ground level obstacles. This is particularly relevant in unfamiliar outdoor situations. This study will determine whether providing plain distance glasses (with extensive counselling and recommendations for use in standing and walking activities) will prevent falls and their consequences over a one year period in older persons who wear bi-, tri- or multi-focal glasses. Pilot studies suggest that most elderly bi-, tri-, or multi-focal wearers at risk for falls are willing to purchase and use a second pair of glasses if the benefit of new plain distance glasses for their vision is demonstrated. We expect that the results of the study will be incorporated into all relevant areas of clinical practice and public health strategies.Read moreRead less
The FREEDOM Study: A RCT Of Sunlight And Calcium To Reduce Vitamin D Deficiency In Older People In Residential Care
Funder
National Health and Medical Research Council
Funding Amount
$838,972.00
Summary
The proposed study emanates from a large ongoing epidemiological study on falls and fractures in the elderly (the FREE study). Falls and fractures are major problems in the elderly. This is the genesis for the FREEDOM (Falls Risk Epidemiology: Effect of vitamin D on skeletal Outcomes and other Measures) intervention study. The FREEDOM study will evaluate the effect of a public health strategy to reduce falls and fractures in older people living in residential care (namely appropriate sun light e ....The proposed study emanates from a large ongoing epidemiological study on falls and fractures in the elderly (the FREE study). Falls and fractures are major problems in the elderly. This is the genesis for the FREEDOM (Falls Risk Epidemiology: Effect of vitamin D on skeletal Outcomes and other Measures) intervention study. The FREEDOM study will evaluate the effect of a public health strategy to reduce falls and fractures in older people living in residential care (namely appropriate sun light exposure and calcium supplementation) in a randomised trial. The primary endpoints of this study will be reduction in falls and change in vitamin D levels. Other endpoints will be change in motor function, mood, bone turnover and fracture incidence. The proposed public health strategy to be examined is readily transferable to routine practice and would have very good feasibility for easy implementation and are generally applicable to the residential care setting, where the study will be conducted. Moreover the proposed approach would be low in cost and does not depend on other health system input. Potentially large numbers of people would benefit from the better understanding of simple methods of securing improved vitamin D status.Read moreRead less
Does An Annual High Dose Vitamin D Supplement Decrease Healthcare Utilisation In Older Women?
Funder
National Health and Medical Research Council
Funding Amount
$104,995.00
Summary
The shorter bleaker days of winter can cause a vitamin D deficiency in Australian women, increasing their risk of osteoporosis and broken bones including hip fracture. New research suggests that the low winter levels of the vitamin may not be good for us in many ways and the NHMRC is funding a Geelong-based study to determine if Austrlia's elderly can improve their overall health by taking a once-a-year dose of vitamin D tablets.
A reduced capacity to recover balance following an imbalance episode contributes to the high incidence of falls in older adults. The goal of the present study is to determine how age-related differences in lower extremity neuromuscular and biomechanical properties are related to balance recovery capacity and falls incidence. A detailed understanding of this relationship is necessary for the development of efficacious exercise-based interventions for the prevention of falls.
Falls and broken bones are costly health problems among the elderly, even more so when there is a growing older population aged over 65 years. In Australia about 1 million older people have at least one fall each year and about 40-60% will sustain major injuries including broken bones. Therefore there is a need to identify effective ways to reduce falls and improve outcomes of those who break a bone, especially of the hip.