Evaluating Technology-Based Fall Prevention Interventions

Study Overview
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Brief Summary
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Approximately one in three older adults fall annually and it is the primary cause of traumatic injury in older adults. While exercise and balance programs have been shown to be effective in reducing fall risk, maintaining behavior change is known to be difficult. Thus additional interventions need to be validated to add to our current armamentarium to reduce falls in older adults. Cognitive training (CT) involves exercises that target specific cognitive tasks, such as memory or processing speed. It has been speculated that routinely performing such tasks may increase functional ability. Recent work has pointed to an increased risk of falls in community-dwelling older adults who have alterations in specific cognitive tasks. Thus the purpose of the proposed study is to demonstrate the feasibility and to explore the effectiveness of a 16 week CT intervention to reduce risk and incidence of fall and improve outcomes up to 1 month post-intervention in a group of community dwelling older adults at risk for fall.

Official Title
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Influence of Cognitive Training on Fall Prevention in At Risk Older Adults

Conditions
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Falls (Accidents) in Old Age

Intervention / Treatment
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* Other: Cognitive Training
* Other: Technology-based Education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 65-89 years old speak and read English live within 30 miles of the University of Washington a score of 4 or higher on the Memory Impairment Screen (MIS-T) regular access to a computer with internet capability (whether at home, friend/family, community center, public library, or other) a positive response to any of the following three fall related questions: i) Have you had two or more falls in the prior 12 months? ii) Are you responding to the advertisement because of a recent fall? iii) Do you have difficulty with walking or balance? <53 seconds on 90 second balance test or gait speed <1m/sec. Exclusion Criteria: current participation in formal cognitive training program currently bedridden or wheelchair dependent

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 89 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br> | Other: Cognitive Training<br>* Web-based cognitive training intervention targeting specific cognitive tasks. Subjects complete 3 training sessions per week with at least 24 hours in between sessions.<br>|
| Other: Education<br> | Other: Technology-based Education<br>* Subjects complete 16 web-based educational modules on healthy aging content. Following each module, subjects complete a learning reflection.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Falls | Falls and Injurious Falls as per Fall Calendar | 16 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Disability | Gill Disability Scale | 8 weeks, 16 weeks, 20 weeks. | 
| Cognitive Assessment | CANTAB Battery (Simple response time, one touch stockings of Cambridge, Stop Signal Task, Spatial Working Memory, Verbal Recognition Memory, Rapid Visual Information Processing) | 8 weeks, 16 weeks, 20 weeks | 
| Gait Assessment | Assessment of Gait Parameters using APDM sensor system | 8 weeks, 16 weeks, 20 weeks | 
| Balance Assessment | Assessment of Balance using APDM sensor system | 8 weeks, 16 weeks, 20 weeks |