Preventing falls through digital healthy ageing

Falls can have significant health implications in people aged over 65. Professor Emma Stanmore talks about developing a digital approach to preventing falls through the Keep On, Keep Up (KOKU) programme.

As global populations age, health systems are under growing pressure to manage the challenges that come with longer lives. Longer life expectancy brings benefits - but also increases the number of people living with frailty, reduced mobility and chronic conditions.

Among the most serious risks facing older adults are falls, which can have devastating health and social consequences. They can lead to serious complications such as hip fractures, where half of patients never regain their former mobility, and 30% die within a year. The wider cost to the NHS exceeds £4.4 billion annually, while social care services already spend more than £23 billion each year supporting those who lose their independence after a fall.

Globally, the financial impact is even greater. In the United States alone, the cost of treating falls exceeds $50 billion a year. With the world's population of over-65s expected to double by 2030, the demand for preventative and scalable health solutions has never been more urgent.

A digital approach to prevention

Manchester researchers are tackling this growing challenge with Keep On, Keep Up (KOKU) - a digital programme that helps older adults maintain strength, balance and confidence at home.

Designed to be easy to use on a tablet or iPad, the 12-week app delivers progressive exercise routines and engaging wellbeing modules that promote long-term health and independence.

Grounded in over two decades of research, KOKU combines clinically proven interventions, such as the OTAGO and FAME falls prevention programmes, with gamified health education. Alongside physical training, users explore topics like hydration, nutrition, bone health and home safety through interactive games and videos. These modules are underpinned by behaviour change techniques such as progress tracking, feedback and rewards, encouraging ongoing participation and motivation.

Clinical trials across Greater Manchester, Nottingham and Texas have shown that the programme delivers significant improvements in balance, strength, confidence and quality of life. Data suggests that completing the KOKU exercises can reduce falls by at least 23%, and by up to 40% with more advanced balance routines.

For many users, particularly those unfamiliar with technology, it also offers a positive introduction to digital health tools - building confidence in using apps to manage wellbeing.

Transforming care through accessibility

KOKU's design allows it to be used across multiple care settings, from hospitals and community centres to care homes and individual households. It is already being adopted by NHS Trusts, local authorities and primary care networks in the UK, and is freely available for individuals to download and use at home.

The programme's low cost and scalability make it a valuable resource for health and social care systems under strain. For every £1 invested, KOKU delivers an estimated £5.78 financial return and a £12.81 societal return through fewer hospital admissions, reduced need for rehabilitation and greater independence among older adults.

Simple analytics dashboards allow service providers to measure impact, track engagement and share data across local and national systems to inform wider health strategies.

A global solution for an ageing world

As the number of older adults grows, innovative digital tools like KOKU offer a blueprint for preventative, person-centred healthcare. By blending academic research with accessible technology, Manchester is demonstrating how evidence-based digital interventions can reduce avoidable harm and promote healthy ageing on a global scale.

Accessible, effective and engaging, KOKU is transforming how older adults stay active and connected - helping people everywhere to keep on, keep up and live longer, healthier lives.