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Background As a result of the COVID-19 pandemic, changes in data collection methods have been introduced in research to ensure continuity despite physical distancing and lockdown restrictions. However, little is currently known about the potential differences in information collected using these traditional face-to-face methods compared to the incorporation of virtual methods to address the above, particularly in studies involving older adults. Aims Our objectives were, therefore, to compare data collected during the pandemic using hybrid methods from older individuals participating in falls research to that collected through traditional face-to-face methods. Methods Participants comprised of individuals recruited to two fall studies which hurdled the start of the COVID-19 pandemic. Both studies recruited individuals aged 60 years and over with at least one fall in the past 12 months, and controls with no history of falls in the past 12 months. Pre-pandemic, individuals were interviewed face-to-face exclusively, those interviews after the start of the pandemic were conducted virtually with physical assessments conducted face-to-face to minimize physical contact. Cognitive, physical, and psychological status were determined using the visual cognitive assessment tool (VCAT), timed-up-and-go (TUG), functional reach (FR), handgrip strength (HGS), and the 21-item depression, anxiety and stress scale (DASS-21). In addition quality of life, physical activity and social participation were also measured. Results Of the 145 participants (median age (interquartile range, IQR) of 73.5 (67-81) years), 69 (47.6%) were interviewed face-to-face, while 76 (53.4%) were assessed using a hybrid method. Participants in both groups had similar age, gender, ethnic breakdown, marital status, education levels, anthropometric measurements, and medication burden. More face-to-face participants had hypertension and fall compared to hybrid participants Differences were observed in presence of fall characteristics, with fewer fallers seeing a doctor and more fallers attending the emergency department after the start of the pandemic. After adjustment for baseline differences, participants interviewed using hybrid status had lower depression scores (odds ratio, OR (95% confidence interval, CI)=0.29(0.14-0.61) and stress scores (OR(95%CI)=0.33(0.15-0.72)), but greater fear of falling (OR(95%CI)=2.16(1.04-4.48)) and reduced social participation (OR(95%CI)=2.64(1.20-5.79)). Conclusion Alterations in recruitment and data collection methods to overcome pandemic restrictions should take into consideration potential differences in individuals who agree to participate as well as the influence of major life events on the psychological status of participants.

Objective To determine the effectiveness of an individually-tailored multifactorial intervention in reducing falls among at risk older adult fallers in a multi-ethnic, middle-income nation in South-East Asia. Design Pragmatic, randomized-controlled trial. Setting Emergency room, medical outpatient and primary care clinic in a teaching hospital in Kuala Lumpur, Malaysia. Participants Individuals aged 65 years and above with two or more falls or one injurious fall in the past 12 months. Intervention Individually-tailored interventions, included a modified Otago exercise programme, HOMEFAST home hazards modification, visual intervention, cardiovascular intervention, medication review and falls education, was compared against a control group involving conventional treatment. Primary and secondary outcome measures The primary outcome was any fall recurrence at 12-month follow-up. Secondary outcomes were rate of fall and time to first fall. Results Two hundred and sixty-eight participants (mean age 75.3 ±7.2 SD years, 67% women) were randomized to multifactorial intervention (n = 134) or convention treatment (n = 134). All participants in the intervention group received medication review and falls education, 92 (68%) were prescribed Otago exercises, 86 (64%) visual intervention, 64 (47%) home hazards modification and 51 (38%) cardiovascular intervention. Fall recurrence did not differ between intervention and control groups at 12-months [Risk Ratio, RR = 1.037 (95% CI 0.613–1.753)]. Rate of fall [RR = 1.155 (95% CI 0.846–1.576], time to first fall [Hazard Ratio, HR = 0.948 (95% CI 0.782–1.522)] and mortality rate [RR = 0.896 (95% CI 0.335–2.400)] did not differ between groups. Conclusion Individually-tailored multifactorial intervention was ineffective as a strategy to reduce falls. Future research efforts are now required to develop culturally-appropriate and affordable methods of addressing this increasingly prominent public health issue in middle-income nations. Trial registration ISRCTN Registry no. ISRCTN11674947

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