PURPOSE: The primary purpose of this study was to evaluate the ability of a mobile application to predict fall risk in older adults in the community.

BACKGROUND: One in three older adults fall each year, and fewer than half talk to their providers about it. It remains the leading cause of fatal and nonfatal injuries, and in 2013, 2.5 million nonfatal falls were treated in the emergency room, with 30% of these patients hospitalized with severe injuries, including traumatic brain injury and fractures. This mobile application, initially designed to assess abnormal postural sway and delayed reaction time in athletes who have suffered a concussion, could be used in an older adult population to detect changes in postural sway and motion reaction time, both predictors in fall risk.

DESIGN: The SWAY application is a Food and Drug Administration–approved medical device that uses the iPhone gyroscope to determine postural sway and reaction to visual stimulus to provide a standardized score. This cross-sectional primary data analysis examined associations between the Senior SWAY results and two traditional measures of fall risk, the Timed Up and Go (TUG) score and patient-reported history of falls.

PARTICIPANTS: Adults age 55 yr or older, living in the community, and able to walk

METHOD: Adults age 55 and older were approached in the community to participate in this study. Adults signed consent before enrolling. The SWAY application includes the following two tests: Centers for Disease Control and Prevention (CDC) fall risk assessment and the Motion Reaction Time.

ANALYSIS: First, descriptive statistics were used to examine the sample; then, univariate analyses were completed to examine associations between tests. For this analysis, both TUG and previous falls were transformed to dichotomous variables.

RESULTS: Fifty-nine adults with an average age of 78 (range = 55–94); 68% female, with an average TUG score of 11.3, and 24% (range = 0-6) with a previous fall in the past 6 mo; average SWAY score 63.9 (range = 41.6– 96.8). Scores for Senior SWAY, including the CDC assessment and the Motion Reaction Time, were all significantly associated with TUG and previous falls (p < .001).

DISCUSSION: The Senior SWAY mobile application examines both postural sway and reaction to visual stimulus using the iPhone gyroscope. Lower Senior SWAY results were significantly related to previously identified fall risks by both the TUG and patient-reported previous falls.

IMPACT STATEMENT: This is the first step in understanding the use of a new mobile application to identify fall risk in older adults. With further testing, Senior SWAY could be used in the clinic to ease identification of adults who may need occupational therapy to mitigate fall risk.