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Otago Exercise Program to Reduce the Rate of Falls in Older Patients with Dementia
Dissertation

Otago Exercise Program to Reduce the Rate of Falls in Older Patients with Dementia

Sidonie Esther Behuhuma
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2026
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Abstract

Background: Falls among older adults are a major public health concern, especially for those with dementia. Contributing factors include impaired cognition, gait instability, and polypharmacy. At the local long-term care facility, 53.1% of residents experienced at least one fall, which is higher than the national average. Evidence supports the use of therapeutic interventions, such as the Otago Exercise Program (OEP), to reduce fall risk. Purpose: This project aimed to implement the OEP over six months. Goals included improving staff knowledge, enhancing resident balance and mobility, and reducing fall rates among adults aged 65 and older with dementia. Methods: This quantitative quality improvement project used a Plan-Do-Study-Act framework at a 60-bed long-term care facility. Staff received OEP training, and their knowledge was assessed with pre- and post-intervention surveys. Eight eligible residents aged 65 or older with mild to moderate dementia were identified; four participated. Baseline, midpoint, and post-intervention data was gathered using the Berg Balance Scale (BBS) and Timed Up and Go (TUG) to assess balance and mobility. Baseline falls rates were obtained from the falls log. Restorative staff delivered the OEP 2-3 times per week. Data from electronic health records were analyzed with descriptive statistics and paired t-tests. Findings: Participants showed significant improvement in balance, with mean BBS scores rising from 20.67 to 41.67 (p = .003). TUG times improved from 68.93 to 55.77 seconds, though this was not statistically significant (p = .071) and no falls occurred during EOP implementation. Small number of participants and attrition limited statistical power. Discussion: The OEP resulted in meaningful improvements in balance and mobility, supporting its use to reduce fall risk for older adults with dementia. Despite implementation challenges, findings support integrating structured exercise programs into long-term care to improve safety and reduce falls.
 Falls fall prevention older adults dementia Otago exercise program long-term care

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