A Cognitive-Behavioral and Exercise Intervention to Reduce Fear of Falling in Older Adults in Long-Term Care: A Pilot Study

Abstract Objective This pilot study evaluated the feasibility of a Cognitive Behavioral Therapy (CBT) and exercise intervention (AGES) to reduce fear of falling (FoF) in older adults in long-term care (LTC) facilities. Method A single-arm, non-randomized pilot study was conducted in three LTC facilities with 19 participants (17 women, 2 men, mean age = 84 years). The intervention consisted of 8 weekly one-hour group sessions led by trained leaders, combining CBT discussions and exercises targeting FoF. Outcome measures included the Falls Efficacy Scale-International (FES-I), the WHO-5 Well-Being Index, and the Timed Up and Go (TUG) test. Gait analysis was performed using a Lidar-based method, developed for this pilot study. Results The intervention did not significantly reduce FoF (FES-I: pre = 27.28, post = 25.67, p = 0.411) or improve well-being (WHO-5: p = 0.125). However, significant improvement in mobility was observed (TUG: pre = 14.68, post = 13.40, p = 0.032). Gait analysis showed marginal improvements in gait parameters. Implementation challenges included recruitment and leader engagement. Discussion The AGES intervention Pilot trial demonstrated feasibility in LTC settings and improved mobility among participants. The small sample size might have limited the detection of significant changes in FoF and well-being. Future studies should aim for larger sample sizes and address recruitment challenges to validate the intervention's effectiveness. Further refinement of gait analysis methods for participants using walking aids is necessary.