Going Outdoors: Falls, Ageing & Resilience

This is an MRC funded project (ref G1001872/1) under the Lifelong Health and Wellbeing programme. The total MRC award is £246k, of which £81k is to Edinburgh College of Art and the School of GeoSciences, University of Edinburgh.
Going outdoors is a key factor in preserving good physical, mental and social health in all age groups, but particularly as people move into older age. Approximately one third of people aged 65+ living in the community fall at least once per year, with many suffering multiple falls which can lead to disability and decreased mobility. Also, fear of falling is a key inhibitor of getting outdoors for older people. The Department of Health Prevention Package (2009) identified a need for research to prevent outdoor falls and decrease the barriers to physical activity that the environment poses. Many of the environmental risk factors (pavement quality, dilapidation, kerb height) associated with outdoor falls appear to be preventable through better design and maintenance. However, research to date has neglected outdoor falls and focused on the indoor environment.

This pilot study explores features of the outdoor environment which shape older people’s resilience to falls. This aim is achieved through a series of research objectives:
1. To consider the role of the outdoor environment in shaping social and local geographical inequalities in health;
2. To explore older people’s perceptions on, and, experiences of, falling (and fear of falling) outdoors;
3. To develop and test innovative methods, tools and techniques to evaluate the relationship between the person who falls (or who has a fear of falling) and the outdoor environment;
4. To develop a clear road map for future, cross-disciplinary research that will be both robust and practicable, to address the most important issues related to ageing, falls, and the outdoors.

The study is 12 months with 4 work packages which bring together a multi-disciplinary group across 7 UK Universities plus AGE UK, Toronto Rehab, Marshalls paving, and the Health and Safety Laboratory. These work packages involve mapping of geographical ‘hotspots’ where older people fall most often; focus groups with older people to identify risk factors for falling; the development of a person-environment fit audit tool to identify environmental interventions; and the development of a pilot protocol to test surface slip of pavement materials.

The synergy of knowledge generated by this pilot testing will allow for the development of a greater understanding of the many factors involved in outdoor falls, with the potential for this to feed into a research agenda and practical tools which will significantly impact on older people’s health and wellbeing.

Going outdoors is important in preserving good physical, mental and social health for everyone but particularly older people. Approximately one third of people aged 65+ living in the community fall at least once per year, with many suffering multiple falls leading to disability and decreased mobility. This fear of falling can prevent older people from getting outdoors. In 2009 The Department of Health identified a need for research to prevent outdoor falls and decrease the barriers in the environment that prevent physical activity. Many of the barriers such as pavement quality, dilapidation, kerb height appear to be preventable through better design and maintenance. However, research to date has rarely looked at outdoor falls, instead focusing on the indoor environment.
This pilot study explores features of the outdoor environment which shape older people’s resilience to falls. This aim is achieved through a series of research objectives:
1. To consider the role of the outdoor environment in shaping social and local geographical inequalities in health;
2. To explore older people’s perceptions on, and, experiences of, falling (and fear of falling) outdoors;
3. To develop and test innovative methods, tools and techniques to evaluate the relationship between the person who falls (or who has a fear of falling) and the outdoor environment;
4. To develop a clear road map for future, cross-disciplinary research that will be both robust and practicable, to address the most important issues related to ageing, falls, and the outdoors.
The study is 12 months with 4 work packages which bring together a multi-disciplinary group across 7 UK Universities plus AGE UK, Toronto Rehab, Marshalls paving, and the Health and Safety Laboratory. These work packages involve mapping of geographical ‘hotspots’ where older people fall most often; focus groups with older people to identify risk factors for falling; the development of a person-environment fit audit tool to identify environmental interventions; and the development of a pilot protocol to test surface slip of pavement materials.
The synergy of knowledge generated by this pilot testing will allow for the development of a greater understanding of the many factors involved in outdoor falls, with the potential for this to feed into a research agenda and practical tools which will significantly impact on older people’s health and wellbeing.