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Virtual fall program assessment for frail Canadian community-dwelling older adults: Examining equitable accessibility
Sophie M Weiss1, Matthew Castelo2,3, Barbara Liu4,5
1Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Digital Health
|June 14, 2023
Summary
Virtual fall prevention program (FPP) assessments during COVID-19 showed similar frailty levels compared to in-person visits. However, virtual care highlighted potential inequities, with increased use of walking aids and cognitive impairments observed in the virtual cohort.
Area of Science:
- Gerontology
- Public Health
- Health Services Research
Background:
- The COVID-19 pandemic necessitated rapid shifts to virtual healthcare delivery.
- Fall Prevention Programs (FPPs) are crucial for maintaining older adult independence.
- Assessing the accessibility and equity of virtual FPPs is vital.
Purpose of the Study:
- To compare patient demographics and characteristics between virtual and in-person Fall Prevention Program assessments.
- To explore equitable accessibility of virtual FPPs during the COVID-19 pandemic.
- To identify potential disparities in care delivery through virtual modalities.
Main Methods:
- Retrospective chart review comparing virtual FPP assessments (during COVID-19) with historic in-person assessments.
- Abstraction of demographics, frailty measures, co-morbidities, and cognitive function.
- Statistical analysis using Wilcoxon Rank Sum and Fisher's Exact tests.
Main Results:
- Thirty patients were assessed virtually, compared to 30 in-person controls (median age 80, 82% female).
- No significant difference in normalized frailty scores (p=0.446).
- Virtual cohort showed increased walking aid use (p=0.015) and poorer clock drawing accuracy (p=0.020), with trends toward higher medication use and IADL assistance needs.
Conclusions:
- Virtual FPP assessments maintained comparable frailty levels to in-person evaluations.
- Virtual care demonstrated benefits but also highlighted potential inequities, particularly for frail older adults with cognitive impairments.
- Findings underscore the need to address accessibility and equity in virtual geriatric care models.
