A national programme to help older people with impairments remain independent

A novel and innovative health promotion exercise intervention, uniquely developed by a national team of researchers and led by Northumbria University, has been used to reduce fear of falling and improve quality of life in older people with impairments such as low vision. This is the first time that such an intervention has been developed specifically for this group, with visually impaired older people themselves helping to design and adapt the intervention. Due to its success, the programme has now become standard practice within the NHS and community and is informing national policy.

Around one in three people over 65 and more than half of those aged 80 and older will suffer a fall each year. Falls can have a major impact on quality of life, and lead to injury, loss of independence and death. In addition, falls are the main reason for nonfatal trauma-related hospital admissions in older people and they cost the NHS around £2.3 billion per year. Exercise programmes that improve strength and balance are shown to reduce the risk of falls in older adults, but as well as not being tailored to certain at-risk populations, interest and commitment to interventions is often poor.

Nicola Adams, Professor of Health Promotion Rehabilitation at Northumbria University is leading a pioneering health intervention study to reduce the risk of falls in specific groups who have a higher risk of falling, such as those with visual impairments or other long-term conditions. The project is already having a major impact on the development and delivery of national falls prevention services for long-term conditions.

The study is primarily funded by a National Institute for Health Research (NIHR)-Public Health Research grant and supported by the NHS, the Newcastle Vision Support and Royal National Institute of Blind People (RNIB). It supports current health and social policy, as well as the UK’s Industrial Strategy, which promotes independence in older people. In addition, it adheres to UK national guidelines for the assessment of pain in older people, which are also recommended by the British Society of Geriatrics.

For the project, the national team led by Professor Adams developed a health promotion programme using adapted exercise interventions for older people with impairments living in the community. To support the delivery of the exercise programme, a training manual (available on the NIHR website) for instructors was created and this is currently being used by companies such as Later Life Training, HealthWORKS and Visibility who are implementing the intervention within the NHS and community. A webinar was then developed to enable health professionals and charities such as RNIB and NSBP to access training on the new exercise intervention.

This forward-looking and ongoing programme of research has valuable implications for the training and delivery of falls prevention strategies at the national level. Notably, the intervention is now set to become standard practice and the training manual used to inform policy and practice. Research findings will also be used to update national clinical guidelines. At the patient level, the webinar will be developed to enable older people who are at risk of falls to carry out prevention exercises and adhere to their current programme.