(MRC DTP) Can smartphone technology reduce loneliness, isolation and depression for older people receiving falls rehabilitation

Each year 35% of people aged over 65years experience a fall, which are a frequent cause of lost independence and quality of life and cost to the health service. Falls lead to loss of confidence, restriction of movement and therefore loneliness and depression. Exercise programmes including strength and balance exercises can significantly reduce the risk/rate of falls and injuries (Gillespie et al, 2011) and provide social and psychological benefits (Hawley et al, 2009).

Adherence to exercise is highly related to social support and group cohesion (Hawley-Hague et al., 2014) therefore interventions that promote this are to be encouraged. Teleconferencing and smartphone technology could be an effective way of encouraging maintenance of exercise and provide additional mental health benefits, reducing loneliness and depression.

Objectives
To establish whether smartphone technology delivered ‘one to one’ and ‘virtual group’ falls rehabilitation, alongside falls alarm and motivational feedback can:
• Improve mental well-being
• Reduce depressive symptoms
• Facilitate long-term adherence to exercise
• Further reduce falls risk.

Hypothesis

Smartphone technology can increase long-term adherence to exercise for older adults, improving mental well-being and further reducing falls risk.

Methods

A mixed methods approach will be used to carry out longitudinal follow-up of an existing cohort of patients taking part in a feasibility RCT, which is testing the use of the technology as an alternative to standard rehabilitation. This study will look at the longer-term benefits of the technology for the patient (long-term prevention). Validated assessment tools will be used to assess the potential impact of the intervention and qualitative interviews will be carried out with older people and carers to establish experiences of using the technology long-term (older adults’ experience of exercising with others without health professionals and the impact on their lives and their carers) and to inform further design of the interfaces/App functionality. Based on Medical Research Council guidance for development and evaluation of complex interventions (MRC, 2008) this work will inform the design of future trials.

Impact

Smartphone technology has the potential to provide:
1. Increased social support, group cohesion, reduced loneliness and improved overall well-being during and after intervention.
2. Maintained exercises and functional outcomes (reduced falls risk/independence)

The intervention has potential to be cost neutral to the NHS/cost saving due to reduced travel-time and reduction in patients re-access to services. It may reduce the need for social care interventions. It will enable the smartphone technology to be exploited to support vulnerable older adults long-term.

http://www.manchester.ac.uk/research/Sarah.tyson/
http://www.manchester.ac.uk/research/Helen.hawley-hague/research