Original article| Volume 95, ISSUE 6, P1060-1066, June 2014

Download started.


Long-Term Participation in Peer-Led Fall Prevention Classes Predicts Lower Fall Incidence

Published:February 06, 2014DOI:



      To investigate the association between length of participation in Steady As You Go (SAYGO) peer-led fall prevention exercise classes for older adults and 12-month fall incidence.


      Twelve-month prospective cohort study.


      Community settings.


      Older adults (N=207; 189 women, 18 men) aged ≥65y (mean age ± SD, 77.7±6.6y) actively participating in SAYGO classes.


      Peer-led fall prevention exercise classes.

      Main Outcome Measures

      Twelve-month prospective fall incidence data were collected by monthly calendars. Falls in the previous year and number of years of SAYGO participation were obtained by baseline questionnaire. Class attendance was monitored weekly by class attendance records.


      Mean length ± SD of SAYGO participation was 4.3±2.5 years (range, 1–10y). Average class attendance was 69%. Crude fall rate was .75 per person-year. Fall incidences at 12 and 24 months were highly correlated (r=.897, P<.001). Longer SAYGO participation (≥3y) resulted in a lower 12-month fall incidence (incidence rate ratio, .90; 95% confidence interval, .82–.99; P=.03) compared with a shorter duration of participation (1–2y).


      SAYGO appears to be an effective fall prevention intervention with a high attendance rate and a lower fall incidence with long-term participation. Prospective controlled studies on long-term participation in peer-led fall prevention exercise programs are needed to confirm and extend these findings.


      List of abbreviations:

      CI (confidence interval), IRR (incidence rate ratio), PY (person-year), SAYGO (Steady As You Go)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Gillespie L.D.
        • Robertson M.C.
        • Gillespie W.J.
        • et al.
        Interventions for preventing falls in older people living in the community.
        Cochrane Database Syst Rev. 2012; 9: CD007146
        • Campbell A.J.
        • Borrie M.J.
        • Spears G.F.
        Risk factors for falls in a community-based prospective study of people 70 years and older.
        J Gerontol. 1989; 44: M112-M117
        • Campbell A.J.
        • Borrie M.J.
        • Spears G.F.
        • Jackson S.L.
        • Brown J.S.
        • Fitzgerald J.L.
        Circumstances and consequences of falls experienced by a community population 70 years and over during a prospective study.
        Age Ageing. 1990; 19: 136-141
        • Tinetti M.E.
        • Speechley M.
        • Ginter S.F.
        Risk factors for falls among elderly persons living in the community.
        N Engl J Med. 1988; 319: 1701-1707
        • O'Loughlin J.L.
        • Robitaille Y.
        • Boivin J.F.
        • Suissa S.
        Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly.
        Am J Epidemiol. 1993; 137: 342-354
        • Todd C.
        • Skelton D.
        What are the main risk factors for falls amongst older people and what are the most effective interventions to prevent these falls?.
        WHO Regional Office for Europe (Health Evidence Network report), Copenhagen2004 (Available at:) (Accessed April 5, 2004)
        • Robitaille Y.
        • Fournier M.
        • Laforest S.
        • Gauvin L.
        • Filiatrault J.
        • Corriveau H.
        Effect of a fall prevention program on balance maintenance using a quasi-experimental design in real-world settings.
        J Aging Health. 2012; 24: 827-845
        • Schwenk M.
        • Lauenroth A.
        • Stock C.
        • et al.
        Definitions and methods of measuring and reporting on injurious falls in randomised controlled fall prevention trials: a systematic review.
        BMC Med Res Methodol. 2012; 12: 50-64
        • Tinetti M.E.
        • Mendes de Leon C.F.
        • Doucette J.T.
        • Baker D.I.
        Fear of falling and fall-related efficacy in relationship to functioning among community-living elders.
        J Gerontol. 1994; 49: M140-M147
        • Yamashita T.
        • Noe D.A.
        • Bailer A.J.
        Risk factors of falls in community-dwelling older adults: logistic regression tree analysis.
        Gerontologist. 2012; 52: 822-832
        • Lamb S.E.
        • Jorstad-Stein E.C.
        • Hauer K.
        • Becker C.
        Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus.
        J Am Geriatr Soc. 2005; 53: 1618-1622
        • Campbell A.J.
        • Robertson M.C.
        • Gardner M.
        Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women.
        BMJ. 1997; 315: 1065-1069
        • Waters D.L.
        • Hale L.A.
        • Robertson L.
        • Hale B.A.
        • Herbison P.
        Evaluation of a peer-led falls prevention program for older adults.
        Arch Phys Med Rehabil. 2011; 92: 1581-1586
        • Glynn R.
        • Buring J.E.
        Ways of measuring rates of recurrent events.
        BMJ. 1996; 312: 364-367
        • Robertson M.C.
        • Gardner M.M.
        • Devlin N.
        • McGee R.
        • Campbell A.J.
        Effectiveness and economic evaluation of a nurse delivered home exercise programme to prevent falls. 2: Controlled trial in multiple centres.
        BMJ. 2001; 322: 701-704
        • Lord S.R.
        • Sherrington C.
        • Menz H.
        Falls in older people: risk factors and strategies for prevention.
        Cambridge Univ Pr, Cambridge2007
        • Luukinen H.
        • Koski K.
        • Hiltunen L.
        • Kivela S.L.
        Incidence rate of falls in an aged population in northern Finland.
        J Clin Epidemiol. 1994; 47: 843-850
        • Vikman I.
        • Nordlund A.
        • Naslund A.
        • Nyberg L.
        Incidence and seasonality of falls amongst old people receiving home help services in a municipality in northern Sweden.
        Int J Circumpolar Health. 2011; 70: 195-204
        • Rubenstein L.Z.
        • Josephson K.R.
        The epidemiology of falls and syncope.
        Clin Geriatr Med. 2002; 18: 141-185
        • Garrett S.
        • Elley C.R.
        • O'Dea D.
        The cost of falls in older adults in the community.
        N Z Fam Physician. 2008; 35: 22-27
        • Hill K.
        • Schwarz J.
        • Flicker L.
        • Carroll S.
        Falls among healthy community-dwelling, older women: a prospective study of frequency, circumstances, consequences and prediction accuracy.
        Aust N Z J Public Health. 1999; 23: 41-48
        • Clemson L.
        • Cumming R.G.
        • Kendig H.
        • Swann M.
        • Heard R.
        • Taylor K.
        The effectiveness of a community-based program for reducing the incidence of falls in the elderly: a randomized trial.
        J Am Geriatr Soc. 2004; 52: 1487-1494
        • McMahon S.
        • Fleury J.
        External validity of physical activity interventions for community-dwelling older adults with fall risk: a quantitative systematic literature review.
        J Adv Nurs. 2012; 68: 2140-2154
        • Fujisawa M.
        • Ishine M.
        • Okumiya X.
        • et al.
        Effects of long-term exercise class on prevention of falls in community-dwelling elderly: Kahoku Longitudinal Aging Study.
        Geriatr Gerontol Int. 2007; 7: 357-362
        • Nyman S.R.
        • Victor C.R.
        Older people's participation in and engagement with falls prevention interventions in community settings: an augment to the Cochrane systematic review.
        Age Ageing. 2012; 41: 16-23
      1. New South Wales Department of Health, Falls—prevention of falls and harm from falls among older people: 2011-2015. Available at: Accessed April 16, 2013.

        • Yardley L.
        • Beyer N.
        • Hauer K.
        • McKee K.
        • Ballinger C.
        • Todd C.
        Recommendations for promoting the engagement of older people in activities to prevent falls.
        Qual Saf Health Care. 2007; 16: 230-234
        • Sherrington C.
        • Tiedemann A.
        • Fairhall N.
        • Close J.
        • Lord S.
        Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations.
        N S W Public Health Bull. 2011; 22: 78-83