Fall Prevention in Older Adults with Cognitive Impairment
Co-Principal Investigators: 1. Dr. Maureen Markle-Reid, McMaster University and the McMaster Aging, Community and Health Research Unit 2. Dr. Diana Sherifali, McMaster University and the McMaster Evidence Review and Synthesis Team Co-Investigators: 1. Dr. Susan Hunter, Western University 2. Dr. Jenny Ploeg, McMaster University 3. Dr. Richard Sztramko, McMaster University 4. Lisa Harrison, Clinical Nurse and Caregiver lived experience Fall prevention interventions are complex and there has been limited literature which summarizes the best strategies and interventions to prevent or mitigate falls in community-dwelling adults with cognitive impairment. The evidence-based guidelines that do exist for fall prevention are mostly clinical in nature and it is unknown the applicability of these guidelines in the community setting and in adults with cognitive impairment. It has become clear from stakeholders such as clinicians and practitioners, that there is a need to better translate research into practice for this unique population. To address these gaps in research and practice, the team of researchers will conduct a systematic review and meta-analysis with the following two objectives: 1) Synthesize the effectiveness of primary and secondary fall prevention interventions in community-living adults (50+ years) with mild to moderate cognitive impairment. 2) Summarize the strategies that support successful feasibility and scalability of fall prevention programs.
Principal investigator: Dr. Susan Hunter, Associate Professor in the School of Physical Therapy at the University of Western Ontario Co-investigators: Dr. Jeff Holmes, OT PhD, Associate Professor, School of Occupational Therapy, University of Western Ontario; Angela Murray RN, Director of Care, McCormick Care Group, London, Ontario The prescription of a mobility aid, such as a walker, is a common treatment given to people with balance and walking problems as it provides physical support and confidence to allow greater participation in society. Yet a completely opposite effect to these intended benefits occurs in people with dementia: the use of a mobility aid triples the risk of falling. The research’s aim is to evaluate an assessment tool across a range of healthcare settings and developing clinical practice guidelines for the prescription, training and ongoing evaluation of mobility aid use in people with dementia. The use of mobility aids currently triples the risk of falling in older adults with dementia. We are currently planning a 3-part webinar series to introduce the screening tool and their implementation guidelines. A series of three webinars on Loop is featuring the ongoing work and research of Dr. Hunter. The first webinar took place on February 27, 2020 and covered the epidemiology and risk factors for falls in people with dementia and mobility aids as a falls risk factor in people with dementia. The second webinar took place on May 28, 2020 and covered the development, reliability and validity of the Safe Use of Mobility Aid Checklist (SUMAC) for 4-wheeled walker use in people in dementia and the application of the SUMAC to case scenarios. Both webinars and related materials are available for download on Loop. The next webinar will take place in Fall 2020.
Prevention of Falls in Mid-Life
Fall prevention research has typically focused on the aging population and children, and little attention has been paid to adults in their mid-life years. ONF is working with Dr. Aleksandra Zecevic from the Faculty of Health Sciences at Western University to identify the types of falls, the fall-related injuries due to falls and best practices to prevent such falls for adults in their mid-life. The intent is to examine whether linkages can be made from falls occurring in mid-life to falls taking place after the age of 65. We hope that this knowledge will inform practice and support the work being done by health practitioners which would minimize the social and economic burden of mid-life falls related to everyday activities. On January 22, 2020, Dr. Zecevic and ONF colleagues presented the initial research findings from the scoping review. The purpose of this scoping review was to answer: (a) what is known from literature about the characteristics of falls occurring in mid-life? and (b) how do falls in mid-life relate to experiences of falling over the lifespan? Webinar participants were invited to share their views and experiences with falls in mid-life as well as their suggestions for future actions. Join Loop to view the webinar, download the pdf slide deck, consult the infographic and the follow up discussion on Loop. Join Loop, the Fall Prevention Community of Practice: www.fallsloop.com
Prevention of Childhood Falls
Co-Principal Investigators: Dr. Alison Macpherson, York University and Dr. Sarah Richmond, Public Health Ontario The purpose of the grant is to create a list of recommended injury indicators as well as data sources to populate the indicators, for public health programming and evaluation in child fall prevention (ages 0 to 9). The list will serve to assist public health researchers and practitioners in identifying and using indicators in their research program and public health interventions for childhood fall prevention. The indicator list will increase systematic surveillance and reporting for child fall prevention - this can ultimately drive policy-related decisions to reduce the burden of fall-related injury in children. Tools and knowledge products will also be developed to assist public health practitioners in using and implementing these indicators in their work.
Falls are the number one cause of ER/Hospitalization visits for children aged 0-6 in Ontario. Source: Toronto Public Health, 2017. With a staggering 53, 327 fall-related ER visits recorded province-wide in 2017, childhood fall prevention strategy has become a key priority for ONF. To address this challenge, ONF commissioned an environmental scan of resources and evidence-informed best practices pertaining to falls in childhood. Designed to serve as a resource for fostering inter-organizational collaboration on child fall prevention and planning child fall prevention initiatives, the scan provides:
- an overview of the nature and scope of fall-related injuries in children, including the key contributory risk factors and risk conditions;
- a summary of evidence-based practices, programs, environmental supports and regulatory measures for preventing fall-related injuries in children;
- a description of the relationship between child fall prevention and the emerging concepts of physical literacy and risky play, which aim to build children’s capacity for healthy physical activity while teaching them to identify and respond appropriately to situations that could lead to injuries (including an injurious fall);
- an overview of Canadian organizations engaged in child fall prevention initiatives; and
- a list of priorities for further research and interventions to strengthen the impact of child fall prevention efforts. Download the environmental scan.