Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2025 Jan;73(1):193-198.
doi: 10.1111/jgs.19148. Epub 2024 Aug 16.

Wrist-worn voice recorders capture the circumstances and context of losses of balance among community-dwelling older adults

Youngjae Lee  1 , Neil B Alexander  2   3 , Lisa Pompeii  4 , Linda V Nyquist  5 , Michael L Madigan  1
Affiliations
Observational Study

Wrist-worn voice recorders capture the circumstances and context of losses of balance among community-dwelling older adults

Youngjae Lee et al. J Am Geriatr Soc. 2025 Jan.

Abstract

Background: Most falls among community-dwelling older adults are due to a loss of balance (LOB) after tripping or slipping. Unfortunately, limited insight is available on the detailed circumstances and context of these LOBs. Moreover, commonly used methods to collect this information is susceptible to limitations of memory recall. The goal of this pilot observational study was to explore the circumstances and context of self-reported LOBs captured by wrist-worn voice recorders among community-dwelling older adults.

Methods: In this pilot observational cohort study, 30 community-dwelling adults with a mean (SD) age of 71.8 (4.4) years were asked to wear a voice recorder on their wrist daily for 3 weeks. Following any naturally-occurring LOB, participants were asked to record their verbal responses to six questions regarding the circumstances and context of each LOB abbreviated with the mnemonic 4WHO: When, Where, What, Why, How, and Outcome.

Results: Participants wore the voice recorder 10.9 (0.6) hours per day for 20.7 (0.5) days. One hundred seventy-five voice recordings were collected, with 122 meeting our definition of a LOB. Each participant reported 0-23 LOBs over the 3 weeks or 1.4 (2.1) per participant per week. Across all participants, LOBs were most commonly reported 3 p.m. or later (42%), inside the home (39%), while walking (33%), resulting from a trip (54%), and having induced a stepping response to regain balance (48%). No LOBs resulted in a fall.

Conclusions: Among community-dwelling older adults, wrist-worn voice recorders capture the circumstances and context of LOBs thereby facilitating the documentation of detail of LOBs and potentially falls, without reliance on later recall.

Keywords: accidental falls; loss of balance; older adults; voice recorder.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Percentage of responses to the six 4WHO questions from all participants combined.
See this image and copyright information in PMC

References

    1. Luukinen H, Herala M, Koski K, Honkanen R, Laippala P, Kivela SL. Fracture risk associated with a fall according to type of fall among the elderly. Osteoporos Int. 2000;11:631‐634. - PubMed
    1. Berg WP, Alessio HM, Mills EM, Tong C. Circumstances and consequences of falls in independent community‐dwelling older adults. Age Ageing. 1997;26:261‐268. - PubMed
    1. Boye ND, Mattace‐Raso FU, Van der Velde N, et al. Circumstances leading to injurious falls in older men and women in the Netherlands. Injury. 2014;45:1224‐1230. - PubMed
    1. Wagner LM, Capezuti E, Taylor JA, Sattin RW, Ouslander JG. Impact of a falls menu‐driven incident‐reporting system on documentation and quality improvement in nursing homes. Gerontologist. 2005;45:835‐842. - PubMed
    1. Jensen J, Lundin‐Olsson L, Nyberg L, Gustafson Y. Fall and injury prevention in older people living in residential care facilities. A cluster randomized trial. Ann Intern Med. 2002;136:733‐741. - PubMed

Publication types