Aktiv Gegen Sturzangst (AGES) is a multicomponent group intervention combining cognitive behavioral therapy and structured exercise to address fear of falling in older adults receiving services from assisted living facilities. This single-arm, non-randomized pilot study evaluated the feasibility of implementing AGES in three assisted living facilities in Switzerland and the feasibility of study procedures and outcome measures for a future controlled trial. Nineteen older adults participated in eight weekly group sessions delivered by trained course leaders. Feasibility outcomes included recruitment, retention, course-leader deployment, protocol adherence, completion of clinical outcome measures, and feasibility of contactless LiDAR-based gait assessment.
AGES was developed as an adaptation of multicomponent approaches to fear of falling for use in German-speaking Swiss assisted living facilities. The intervention consisted of eight weekly group sessions of approximately 60 minutes combining cognitive behavioral therapy-based discussion and reflection with structured balance, strength, mobility, and flexibility exercises. Sessions were delivered by trained facility-based course leaders. The pilot primarily assessed the feasibility of recruitment and retention, course-leader training and deployment, intervention delivery, completion of proposed outcome measures, and LiDAR-based gait assessment. Clinical measures included the Falls Efficacy Scale-International (FES-I), World Health Organization-5 Well-Being Index (WHO-5), and Timed Up and Go test (TUG). The study was exploratory and was not designed or powered to establish intervention effectiveness.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
19
Eight weekly group sessions delivered by trained course leaders. Sessions included cognitive behavioral therapy-based discussion and reflection addressing emotions, automatic thoughts, safety behaviors, assumptions, goal setting, and self-management, combined with structured exercises performed in seated or supported-standing positions where appropriate.
Domicil Spitalackerpark
Bern, Canton of Bern, Switzerland
Alterswohnheim Büttenberg Biel
Biel/Bienne, Canton of Bern, Switzerland
Senevita Résidence Beaulieu Murten
Murten/Morat, Canton of Fribourg, Switzerland
Course-leader deployment
Number and proportion of trained course leaders who subsequently delivered an AGES intervention group
Time frame: During the 8-week intervention period
Participant retention
Number and proportion of enrolled participants retained through completion of the intervention
Time frame: Baseline to approximately 8 weeks
Completion of clinical outcome measures
Number and proportion of participants providing paired FES-I, WHO-5 and TUG assessments
Time frame: Baseline and approximately 8 weeks
Protocol adherence
Number of delivering course leaders reporting delivery according to the standardized intervention manual without major deviations
Time frame: Through approximately 8 weeks
Feasibility of LiDAR gait assessment
Proportion of participants in whom LiDAR measurement could be acquired and proportion of acquired measurements yielding usable processed gait data
Time frame: At approximately Week 8, toward the end of the 8-week intervention period
Falls Efficacy Scale-International (FES-I)
The Falls Efficacy Scale-International (FES-I) is a 16-item questionnaire assessing concern about falling during physical and social activities. Each item is scored from 1 (not at all concerned) to 4 (very concerned), giving a total score ranging from 16 to 64. Higher scores indicate greater concern about falling and therefore a worse outcome.
Time frame: Baseline and approximately 8 weeks
World Health Organization-5 Well-Being Index (WHO-5)
The World Health Organization-5 Well-Being Index (WHO-5) is a 5-item questionnaire assessing subjective psychological well-being over the previous two weeks. Each item is scored from 0 (at no time) to 5 (all of the time), giving a total raw score ranging from 0 to 25. Higher scores indicate greater psychological well-being and therefore a better outcome.
Time frame: Baseline and approximately 8 weeks
Timed Up and Go (TUG) Test
The Timed Up and Go (TUG) test assesses functional mobility. Participants are timed, in seconds, while standing up from a chair, walking 3 meters, turning, walking back, and sitting down. The outcome is the time required to complete the test. Lower times indicate better functional mobility, whereas higher times indicate worse mobility.
Time frame: Baseline and approximately 8 weeks
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