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Evaluation of a peer-led falls prevention program for older adults
Debra L Waters1, Leigh A Hale, Linda Robertson
1Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand. debra.waters@otago.ac.nz
Objective:
To evaluate measures of strength and balance and falls incidence in participants attending fall prevention exercise classes taught by volunteer peer leaders, paid professional (Age Concern Otago group), or a comparison class (comparison group).
Design:
Quasi-experimental evaluation with 12-month follow-up.
Setting:
Community.
Participants:
Older adults with increased fall risk (N=118; mean age, 75.5 y; age range, 65-94 y), with 23% drop out at 12 months.
Intervention:
Peer-led group (n=52) and Age Concern Otago (n=41) weekly 1-hour strength and balance classes adapted from a home-based nurse/physical therapist-administered program and comparison group (n=25) 1-hour weekly seated exercise classes.
Main Outcome Measures:
Timed Up and Go test, 30-second chair stand, functional reach, step touch, Single Leg Stand, and balance confidence at baseline, 10 weeks, and 6 and 12 months. Falls diaries collected monthly for 12 months. Continued exercise participation questionnaire at 6 and 12 months.
Results:
At baseline, the peer-led group achieved normative standards on most tests and performed significantly better than the Age Concern Otago and comparison groups (overall P<.05). The Age Concern Otago group reached normative standards on most tests at 10 weeks. Functional improvements were similar in the peer-led group and Age Concern Otago groups from 10 weeks to 12 months, and all functional measures were significantly greater than in the comparison group (overall P<.02). Poisson regression showed a tendency for a 27% decrease in falls for the peer-led group compared with the comparison group (incidence rate ratio [IRR], .73; 95% confidence interval, .48-1.1; P=.07). Continued participation in strength and balance classes at 12 months was greater in the peer-led group and Age Concern Otago groups compared with the comparison group.
Conclusions:
This peer-led model maintained measures of strength and balance and was superior to seated exercise. People in the Age Concern Otago group chose to continue these classes over other activities, whereas the comparison group had discontinued exercise classes by 12 months. Peer-led classes may decrease the fall incidence, although larger studies are needed to confirm this finding.
