Mind the Care Gap

Introduction

A care gap is a discrepancy between best practices and the care that is actually provided. The care gap in fall prevention among seniors presents a significant challenge in ensuring their overall well-being and healthcare. Falls among older adults pose a serious threat, leading to injuries, trauma, and substantial healthcare costs. Despite the accessibility of healthcare and available evidence-based solutions, over the last two decades the fall rate amongst older adults has continued to increase. This care gap necessitates a more comprehensive approach to identify and address fall risk.

This white paper aims to explore the underlying causes of the care gap in fall prevention and propose innovative solutions to bridge this critical divide. 

The Cost of Falls

Falls are the leading cause of trauma deaths and injuries among older adults, resulting in severe physical and psychological consequences. Approximately one in four individuals aged 65 and above experiences a fall every year. In fact, falling is currently ranked as the fifth most expensive health condition in terms of healthcare spending costing over $67 billion annually [1]. Despite the high prevalence of falls and their immense impact, there are persistent care gaps that hinder effective fall prevention.

The Care Gap

One contributing factor to the care gap is the failure to identify individuals at risk of falling with current clinical tools. For instance, relying solely on fall history, a commonly used tool, is insufficient, as less than half of patients actually report falls to their physicians [2]. Functional tests are sometimes used to assess fall risk, but require an experienced practitioner and time; furthermore, they have been shown to be less accurate in predicting future falls than prior fall history. Consequently, without accurate identification of those prone to falling, appropriate care and preventive measures cannot be provided [3].

Moreover, although seniors aged 65 and above typically visit healthcare providers annually, either for condition management or for a Medicare Annual Wellness Visit, falls and fall risk screenings are often overlooked. Despite guidelines requiring fall risk screening and personalized prevention plans, often this takes the form of generic advice about clutter in the home. Thus care gap persists, with falls continuing to increase by 1.5% annually from 2016-2019 [4].

The care gap in fall prevention among seniors stems from various factors, including accessibility to healthcare, social issues, and deficiencies within clinical practices. Addressing this care gap is crucial to enhance the well-being of seniors, reduce the incidence of falls, and alleviate the burden on healthcare systems.

Solution Overview

In response to the care gap in fall prevention, an innovative solution offers a comprehensive approach to improve fall risk identification, engage patients and identify appropriate preventive measures.

ZIBRIO’s cutting-edge BrioCore® technology uses center of pressure measurements from a 60 second standing test. The technology applies artificial intelligence to distinguish patterns of stability and instability in the user’s postural control. By leveraging a scientifically validated algorithm, the ZIBRIO Stability Scale can accurately evaluate an individual's fall risk and provide actionable insights. Furthermore, the system is sensitive enough to detect small changes (both positive and negative) to support an iterative approach to appropriate interventions.

The key feature of the Stability Scale is its ability to measure and analyze dynamic postural stability, which is a crucial indicator of balance and stability. Through a quick and non-invasive assessment, this personalized assessment accurately identifies 2-5 times more people at high risk for future falls than other clinical tools [5], providing a robust first step in effective fall prevention for patients. ZIBRIO's solution extends beyond risk identification. It empowers healthcare providers with valuable information to create personalized care plans and interventions. By combining measured fall risk with medical record data and lifestyle factors, tailored interventions can be implemented, including exercise programs, environmental modifications, and education on fall prevention strategies.

The implementation of ZIBRIO technology is flexible and tailored to individual clinics and use cases. Individuals can perform the balance and fall risk assessment in the comfort of their own home or in clinical settings with minimal effort. Accompanying software generates comprehensive reports that highlight fall risk levels and actionable recommendations.

ZIBRIO's solution has already shown promising results in improving fall prevention efforts. Initial studies and real-world implementations have demonstrated a remarkable reduction in falls among individuals who utilized the Stability Scale as part of their fall prevention strategy [6]. By accurately identifying those at risk and providing personalized interventions, ZIBRIO technology has the potential to significantly enhance the safety and well-being of seniors.

Conclusion 

Addressing the care gap in fall prevention among seniors is of paramount importance to ensure their well-being and reduce the significant burden on healthcare systems. Falls pose a major threat to older adults' health and quality of life, yet current approaches have been shown to be woefully inadequate. 

However, there is hope. ZIBRIO’s Stability Scale and fall prevention programming offer a transformative approach to bridge the care gap in fall prevention. By leveraging advanced technology and a scientifically validated algorithm, ZIBRIO’s solution accurately assesses an individual's fall risk and provides personalized interventions. Through targeted exercises, environmental modifications, and education, ZIBRIO empowers healthcare providers and caregivers to develop comprehensive fall prevention strategies tailored to each individual's unique needs.

By effectively identifying fall risks, implementing personalized interventions, and promoting a proactive mindset, ZIBRIO has the potential to significantly reduce falls among older adults, improve outcomes, and alleviate the burden on healthcare systems. We seek to empower healthcare providers and caregivers with the knowledge and tools required to effectively reduce falls among seniors. Our objective is to enhance the quality of life for older adults by closing the care gap, improving outcomes, and reducing healthcare costs.

It’s time to work toward a future where falls are not accepted as a typical part of the aging process, and the well-being of older adults is prioritized. By closing the care gap, we can create a society that supports healthy aging, independence, and the overall betterment of our aging population.

References

1. Dieleman, J. L., Cao, J., Chapin, A., Chen, C., Li, Z., Liu, A., Horst, C., Kaldjian, A., Matyasz, T., Scott, K. W., Bui, A. L., Campbell, M., Duber, H. C., Dunn, A. C., Flaxman, A. D., Fitzmaurice, C., Naghavi, M., Sadat, N., Shieh, P., Squires, E., … Murray, C. J. L. (2020). US Health Care Spending by Payer and Health Condition, 1996-2016. JAMA, 323(9), 863–884. https://doi.org/10.1001/jama.2020.0734

2. Stevens JA, Ballesteros MF, Mack KA, Rudd RA, DeCaro E, Adler G. Gender differences in seeking care for falls in the aged medicare population. Am J Prev Med. (2012) 43:59–62. doi: 10.1016/j.amepre.2012.03.008

3. Verghese J. Person-Centered Fall Risk Awareness Perspectives: Clinical Correlates and Fall Risk. J Am Geriatr Soc. 2016;64(12):2528-2532. doi:10.1111/jgs.14375

4. Hoffman G, Franco N, Perloff J, Lynn J, Okoye S, Min L. Incidence of and County Variation in Fall Injuries in US Residents Aged 65 Years or Older, 2016-2019. JAMA Netw Open. 2022;5(2):e2148007. doi:10.1001/jamanetworkopen.2021.48007

5. Forth, Katharine E., et al. "A postural assessment utilizing machine learning prospectively identifies older adults at a high risk of falling." Frontiers in medicine 7 (2020): 591517.

6. Forth KE, Layne CS and Madansingh SI (2021) Self-Monitoring of Balance Performance Can Reduce the Rate of Falls Among Older Adults. Front. Sports Act. Living 3:680269. doi: 10.3389/fspor.2021.680269