Falls Prevention for people with diabetes

Research Priority: Optimising health and wellbeing
Researchers: Claudia Meyer, Anna Chapman, Angela Joe, Duncan Mortimer
Research partners: Centre for Health Economics, Monash University
Study population: Home and Community Support client database
Funding support: GW Griffiths Foundation

For an older person, a fall can cause injury, loss of confidence and a reduction in activity and independence. Older people with diabetes have a 67 per cent greater chance of falling than the general community-dwelling older population.

This project profiled older people aged ≥65 years with diabetes who had a history of falls and received home-based nursing services in 2014 with the aim of:

• identifying predictors of their falls risk
• understanding current community health and aged care service provision
• estimating future service needs and associated costs
• developing an education module for community health workers about falls prevention for people with diabetes.

Profile: Older people with diabetes receiving Home and Community Support services from Bolton Clarke in 2014 had far greater rates of falls than the non-diabetic general older population. They were equally as likely to be male as female, but more likely to have been born outside of Australia. They were more likely to reside in lower socio-economic areas and have multiple health conditions. Falls data was somewhat limited, but of the existing data, over 25 per cent of those people reporting a fall have diabetes. People with diabetes with a history of falls were more likely to have a carer, suggesting they were becoming increasingly frail.

Cost-benefit analysis: Our cost-effectiveness analysis estimated the impact of an intensive, supervised exercise program for people with diabetes and peripheral neuropathy. We found the exercise program plus usual care (their usual health and medical care) is costlier, yet more effective than usual care alone. The exercise plus usual care yields an additional 5.33 quality-adjusted life-years (QALYs) per person due to a reduction in falls per person, falls-related hospital admissions and delayed admission to residential aged care.

Development of an online training module: In collaboration with our Learning and Organisational Development team, we developed a diabetes and falls online module for community-based nurses, allied health and personal care workers.

Publications

Chapman, A., & Meyer, C. (2017). Falls prevention in older adults with diabetes: A clinical review of screening, assessment and management recommendations. Diabetes & Primary Care Australia, 2(2), 1-6.

Meyer, C., Hill, S., Hill, K., & Dow, B. (2017). Sharing knowledge of falls prevention for people with dementia: Insights for community care practice. Australian Journal of Primary Health, 23(5), 464-470.

Meyer, C., Hill, K., Hill, S., & Dow, B. (2019). Falls prevention for people with dementia: A knowledge translation intervention. Dementia. doi:10.1177/1471301218819651.

Meyer, C., Hill, K., Hill, S., & Dow, B. (2019). Inclusive decision-making for falls prevention: A discussion tool for use with people with dementia and their caregivers. Journal of Aging and Physical Activity. doi: 10.1123/japa.2018-0167.

Renehan, E., Meyer, C., Elliott, R., Batchelor, F., Said, C., Haines, T., & Goeman, D. (2019). Post-hospital falls prevention intervention: A mixed-methods study. Journal of Aging and Physical Activity, 27(2), 155-165.

Conference Presentations

Meyer, C. (2018). The translation of falls prevention knowledge for people living with dementia: An Australian community perspective. Australian Association of Manual Handling of People Conference, Melbourne, Australia.

Meyer C. (2019). Healthy ageing and falls prevention. Knox Men’s Shed, Melbourne.

Meyer, C. (2018). The upscale of evidence-based falls prevention programs: Lessons learned. Paper presented at the Australian and New Zealand Falls Prevention Conference, Hobart, Australia.

Meyer, C., Hill, K., Ory, M., & Tan, M. (2017). Implementing community-based falls prevention research into practice: International perspectives. Paper presented at IAGG, San Francisco, U.S.A.

Meyer, C., Chapman, A., Renehan, E., Hill, K., & Mortimer, D. (2018). Exercise to prevent falls among people with diabetes: Review and cost analysis. Paper presented at the Australian and New Zealand Falls Prevention Conference, Hobart, Australia.