JMIR Publications

ABSTRACT

Background:

Chronic diseases such as diabetes, cancer, heart disease, stroke and Alzheimer’s disease increase as people age. Three out of four adults in the United States have more than one chronic disease. Chronic disease can greatly affect an individual’s ability to age in place by decreasing the ability to perform activities of daily living such as bathing, dressing, cooking and taking medications. The inability to perform these activities can also restrict a person’s desire to interact with others, creating or increasing social isolation. In turn, social isolation can lead to depression which can decrease one’s ability to care for themselves which also affects the ability to age in place. Social isolation in the older adult has also been linked to increased falls. Physical activity programs such as the Otago exercise program can improve community dwelling older adults’ strength and balance and decrease the chance of falls. Group physical activity can also decrease social isolation.

Objective:

A telehealth delivered physical activity program was implemented within two low-income older adult housing properties utilizing the Otago exercise program, a physical therapy program endorsed by the Centers for Disease Control to improve balance and strengthening in community dwelling older adults and by the National Council on Aging as the highest level of evidence for fall prevention programs. Participants were also given wearable activity monitors, Fitbits, to help track their activity. The goal of this project was to increase older adults daily physical activity in hopes of decreasing chronic disease morbidities, disability and falls and decrease social isolation.

Methods:

The Otago exercise program was conducted via telehealth twice weekly for 12 weeks. Participants also wore Fitbit activity trackers to encourage physical activity outside of the group classes. Post-intervention qualitative interviews were conducted, recorded, transcribed and analyzed using discourse analysis.

Results:

Twenty-one older adult participants from two low-income properties participated in the 12-week telehealth physical therapy program. Post-intervention qualitative interviews revealed that the two sites were very different in their participation in the program and their main concerns surrounding aging-in-place. While one site had a community-oriented outlook and enjoyed participating in physical activity together, the other site had very few participants and referenced depression and social isolation as main concerns.

Conclusions:

A telehealth physical therapy led intervention to increase physical activity in low-income older adults aging-in-place was successfully implemented and attended; however, it became clear in post-intervention qualitative interviews that social isolation and depression were prevalent and mental health needs to be addressed along with physical health to encourage successful aging-in-place.