A RCT of cognitive-only and cognitive-motor training to prevent falls in older people
Dr Daina Sturnieks, Prof Stephen Lord, Dr Jasmine Menant, Associate Professor Kim Delbaere, Prof Michael Valenzuela
To date, no studies have examined the potential for cognitive or cognitive-motor training to prevent falls in older people, despite good evidence of fall-related cognitive and physical improvements following both intervention types. Building on our initial work, we have developed and validated a home-based computerised training intervention that can be delivered identically, either while seated (cognitive) or while standing and undertaking balance exercises (cognitive+motor). This unique design will allow us to assess whether cognitive and cognitive+motor training can prevent falls, as well as the neural, physiological, physical and neuropsychological mechanisms behind the intervention effects. We will conduct a definitive RCT of 750 people aged 70+ years to determine the effects of cognitive (n=250) and cognitive+motor training (n=250), compared with a no-intervention control group (n=250), in preventing falls in older people. In addition, we will: (i) compare the size of the effects of cognitive+motor with cognitive training on reducing falls; (ii) examine the effects of cognitive+motor and cognitive training on physical function (i.e. balance, gait, mobility), neuropsychological function (i.e. cognitive performance) and neural plasticity (i.e. changes in brain structure and function), and (iii) calculate the cost effectiveness of delivering the interventions. This novel intervention will uncover the potential for cognitive and cognitive-motor training to prevent falls in older people. With our unique design, we will assess the efficacy of both cognitive and the cognitive-motor exercises on fall rates in addition to associated neural, physical and neuropsychological functions. Our project will also uncover cognitive-motor interactions and their neural pathways related to falls, via state-of-the-art imaging techniques that measure brain structure and functional changes. This intervention addresses both physical and cognitive fall risk factors. It holds promise for a cost-effective fall prevention strategy with multiple health benefits for older people.