Falling short: Recruiting elderly individuals for a fall study

Despite the importance of movement and activity indicators in predicting the risk of falls in older adults, collection and analysis of such data are limited. The dearth may result from recruitment challenges faced by fall-related studies that capture data on movement and activity in older adults. This article addresses recruitment and sampling methodology issues and draws attention to the gap in best practices left by previous literature. Authors conducted a systematic review of methods used to recruit elderly individuals for “activity-related fall studies” that assessed subjects’ movement and mobility, and investigated incidence of real falls. The review highlighted effective recruitment strategies and identified challenges across several settings. Literature review findings were compared to recruitment challenges encountered in an activity-related fall study from 2011, focused on enrolling a target group of older adults with both high risk of falling and the requisite cognitive capacity to adhere to activity protocols. The analysis yielded several recommendations for improving recruitment of older adults for activity-related fall studies, including: recruiting from community-based settings; utilizing short-term activity protocols to promote involvement among institutionalized elderly; establishing eligibility criteria that may include those with lower cognitive functioning, mobility restrictions, and co-morbidities; employing direct-mail recruitment methods; and utilizing intermediaries to recruit institutionalized elderly.

► Data on natural movement, physical activity, and real falls among older adults are imperative to fall prevention, but limited.
► Eligibility criteria, sampling method, and mode of outreach affect recruitment rates.
► Recruiting a target group of cognitively aware elderly people who are at risk for falling is particularly challenging.
► Suggestions for strategies to improve recruitment across settings are offered.
► Researchers must be mindful of trade-offs between study objectives and implementation constraints.