Few older adults participate in fall reduction programs, study says

By Emilio Perez Ibarguen, Capital News Service

LANSING—Since 2021, Central Michigan University has offered adults 65 and older home safety assessments, physical training and individualized plans to reduce their risk of falling.

The program, which targets people who have previously fallen, relies on referrals to older adults from emergency rooms in Bay, Clare, Clinton, Eaton, Gratiot, Ingham, Isabella, Midland and Saginaw counties.

Although participation in its Living FREE program costs nothing, the program has little engagement from its target audience, CMU researchers found.

Their findings were published in the American Congress of Rehabilitation Medicine’s Archives of Physical Medicine and Rehabilitation.

Other initiatives targeting falls among older adults, such as tai chi classes, have higher engagement.

Falls are the leading cause of injury for adults 65 and older, according to the Centers for Disease Control and Prevention.

More than one in four older adults in Michigan — 512,548 people — reported falling in 2020.

Living FREE, part of CMU’s Healthy Aging Initiative, aims to reduce subsequent falls through educational sessions, home safety assessments and advice on exercise programs.

However, from September 2021 to November 2023, only 65 of the 923 people — 7% — who were referred to the program actively participated.

Over 80% of people referred to the program either declined to take part or didn’t respond to attempts to contact them.

Low engagement is a problem with “a lot” of CMU’s programs, and with medicine broadly, said Alex Forrest, the administrative coordinator of research projects at the school.

“A lot of it comes down to, when you call older adults, they don’t pick up the phone,” Forrest said.

Forrest’s theory for that pattern, he said, is that the American Association of Retired Persons has succeeded — maybe too well — at teaching older adults to not answer calls from unknown numbers as a defense against scammers.

People who answered the phone but declined to participate in Living FREE often dismissed the reason for their fall, didn’t understand that falls are preventable or said they didn’t need intervention since their fall didn’t result in an injury, according to the researchers.

Despite the low engagement rates, Forrest said the program has positively impacted at least some lives.

“The way I see it, that’s 65 people who weren’t going to get this care otherwise,” he said.

While Living FREE focuses on people who have already been to an emergency room for a fall, Michigan State University Extension’s Crawford County office offers two classes for all older adults.

Its most popular program is the Tai Chi for Arthritis and Fall Prevention class, said health and nutrition educator Nicole Wethington.

Studies have shown that tai chi, a low-impact exercise that originated in China as a martial art, can improve balance and functional reach, which reduces the risk of falling.

Wethington added that tai chi encourages people to be mindful of how they move around in everyday life to prevent falls.

Classes are offered in person at libraries and senior centers across the state, as well as virtually.

The virtual tai chi classes came about during the COVID-19 pandemic but were so popular that it remains an option.

“A lot of folks really enjoy being able to join from their living room,” Wethington said. “They don’t have to drive, especially in the wintertime when the snow is a big, big deal.”

CMU also offers virtual versions of its most popular class, the Otago-Exercise Program, although Forrest noted that the in-person version remains the most popular.

“Older adults, for potentially obvious reasons, really don’t like virtual versions of things,” Forrest said. “If you can get there in person, that is very much their preference.”