ACTIVE: Adding Life to Years in Cognitive Frailty by Preventing Falls

With age, some individuals become physically frail and experience difficulties in their thinking abilities (i.e., cognitive frailty). As a result, they are at risk for poor or negative health events (e.g., falls) and outcomes after such events. Falls are the leading cause of death due to unintentional injuries in those aged 65 years or over and are the third leading cause of disability worldwide. Falls among older adults with cognitive frailty often cause sudden and disproportionally severe change in health state from one of independence (e.g., living in their own homes) to one of dependence (e.g., residing in a long-term care facility). We currently do not know how we can prevent falls in older adults with cognitive frailty. Based on our prior work in falls prevention, we aim to address this knowledge gap by conducting a 12-month study of a home-based exercise program, delivered by physical therapists, in 328 community dwelling adults aged 70 to 89 years old, with cognitive frailty and a history of falls. To increase the likelihood older adults will follow through with the home-based exercise program, we will provide iPads and an exercise app that records exercise goals, provides daily reminders, and tracks completion of exercise sessions. Additionally, physical therapists work regularly with each older adult on exercise goals and action planning specific to each individual. Given the immense health and financial burden imposed by falls, especially among older adults with cognitive frailty, our proposed study could have major benefits. The results will guide future strategies to positively add life to years among people with cognitive frailty.