Dr Mei Ling (Mae) Lim

The INTERgenerAtional Clinical Trial In at risk Older adults and preschool childreN (INTERACTION) (A

There is increasing evidence to show that intergenerational interaction is beneficial for older adults and children alike. Higher levels of social engagement in older adults have been associated with better physical and cognitive function and wellbeing. Time spent with older adults has been linked to enhanced social and personal skills in children. However, familial intergenerational interaction is falling despite rising numbers of community-based older adults. In Australia alone approximately 15% of the total population are aged 65 and over, up from 5% in the 1920s and estimated to increase to 22% (8.8 million) in the next 30-40 years. Employment and economic factors drive greater geographical mobility of working age adults, resulting in increased separation from older family members with 40% of Australians aged 75-84 and 51% of those 85 and over living alone. Recent television series in Australia and the United Kingdom, have raised awareness and enthusiasm for intergenerational activities as an opportunity that could be realised within communities. However, while intergenerational programs are gaining in popularity globally, evidence for best practice in this area remains scarce. 

In the INTERACTION trial led by Associate Professor Ruth Peters, we are collecting data to help us understand whether an intergenerational program (that is bringing older adults and pre-schoolers together to complete purposeful structured activities) helps to reduce frailty in the older adults. We are also measuring what happens to the children as we think it will help them with things like school readiness.  

Our INTERACTION trial builds on our previous pilot work in the Intergenerational Integration Initiative (3i) project. In our previous work we answered three questions: We systematically reviewed the scientific evidence for community-based intergenerational programs and found that this was lacking. We asked the public and local community members what they thought about intergenerational programs and found that people are supportive and perceive such programs to be helpful. Finally, we ran a successful small pilot program in a Sydney community to test whether such programs were feasible. Our published work on the 3i project can be found here https://pubmed.ncbi.nlm.nih.gov/33567363/, and here https://www.mdpi.com/2076-0760/10/10/374  

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Reducing Fear of Falling and Activity Avoidance in Older Adults with disproportionate levels of fear

Catastrophizing thoughts about falls can trip people up. We are now looking for programs that can help reduce concern about falling in older people.

Falls and fear of falling affect many older adults and can impose limitations upon daily activities. Over one third of community dwelling older adults fall each year with about 15% of falls being injurious. However, over two thirds of older adults express fear of falling during common daily activities, making it more common than falls itself. Fear of falling has been associated with needless restriction in physical and social activities with consequent negative impacts on lower quality of life.

Previous research has suggested that fear of falling can be reduced through cognitive behavioural therapy and balance exercise programs. We are collaborating with Black Dog Institute to investigate the effectiveness of an online cognitive behavioural program (myCompass) versus a health education program for 6 weeks at reducing concerns about falling in community-dwelling older people. The intervention consists of a fully-automated cognitive behavioural therapy program (myCompass) delivered through a tablet or computer in people’s homes with no therapist input, including evidence-based and interactive psychological modules that users can complete via the internet on a tablet or computer in their homes.

Health literacy on falls in older people

An informed and engaged older adult who values health promotion, protection, and preparedness is vital to promote uptake and adherence to any health and fall prevention programs.

According to the Australian Bureau of Statistics, about 60 per cent of Australians (15-74 years old) have less than adequate levels of health literacy and only 6% of the population have high health literacy. Health literacy was also found to be lower in old age. The majority of Australians with inadequate health literacy were aged 65 to 74 years. Similarly, in another Australian survey, only 8% of 1454 older adults were aware that balance training can prevent falls, or that falls could be prevented at all. This is indicative of poor health literacy among older Australians related to fall risk and fall prevention. With the increasing complexity of health information and services, health literacy is an issue for older Australians. Health literacy may affect individuals’ understanding of health information and in turn influence their health decisions and uptake of health preventive interventions such as engaging in physical activities to prevent falls.

This project will address a crucial gap in empowering older adults to take care of their own health and increase the uptake and efficacy of evidence-based fall prevention programs. An informed and engaged older adult who values health promotion, protection, and preparedness is vital to promote uptake and adherence to any health and fall prevention programs.