Near Falls in the Singapore Community-Dwelling Older Adults: A Feasibility Study

Abstract Background A near fall is defined as a loss of balance that would result in a fall if sufficient balance recovery manoeuvres are not executed. Compared to falls, near falls and its associated balance recovery manoeuvres have been understudied. Older adults may not recognise a near fall or identify the use of their balance recovery manoeuvres to prevent a fall. The consensus on the methods to collect near fall data is lacking. The primary objective of this study was to determine the feasibility of recruitment and retention. Secondary objectives were to establish evidence that Singapore community-dwelling older adults can identify near falls and associated balance recovery manoeuvres. Texting and phoning methods were explored as reporting methods. Methods This study took place in Singapore (September to October 2019). Participants were healthy, community-dwelling adults aged 65 or older. Recruitment was done through poster advertisement, and all participants gave informed consent. Participants attended a briefing session and reported their near fall or fall incidence over 21 days using either daily texting or phoning. The primary outcome measures were the recruitment rate, retention rate, preferred modes for data reporting and ability to report near falls or falls. Secondary outcomes included the self-reported incidence of falls and near falls. Results Thirty older adults were recruited in five weeks. All participants completed the study. They understood near fall concepts and were able to report the occurrence and relevant balance recovery manoeuvres used to prevent a fall. 87% (26/30) chose to text while 13% (4/30) selected phoning as their reporting method. One actual fall (0.16%) out of 630 responses was reported. Thirty-six incidents (5.7%) of near falls were recorded. Sixteen participants (53.3%) experienced near falls and half of this group experienced two or more near falls. Use of reach-to-grasp strategy (36%), compensatory stepping (52.8%), and other body regions (11.2%) were used to prevent the fall. Conclusions The study provided evidence that studying near falls in Singapore community-dwelling older adults is feasible and can be applied to a large-scale study. Recruitment and retention rates were good. Older adults were able to identify near falls and balance recovery manoeuvres. Both texting and phoning were feasible reporting methods, but texting was preferred.