ArticleNPJ digital medicine2026
Adherence trajectories and predictors of digital balance exercise for fall prevention in community-living older people.
Article in NPJ digital medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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9 authors.
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Abstract
Long-term adherence to exercise delivered through digital health interventions is critical but remains a major challenge, particularly among older people. We pooled intervention-arm data from two randomised controlled trials in 511 community-living older people who participated in a home-based digital balance exercise programme for 52 weeks. Weekly adherence was automatically recorded and expressed as percentage of prescribed dose. Group-based trajectory modelling identified distinct trajectories of adherence and multinomial adaptive lasso regression examined cognitive, physical, demographic and psychological predictors of trajectory group membership. Eight adherence trajectories emerged: overachievers (3.9%), consistent adherers (8.2%), fluctuating adherers (23.1%), intermittent adherers (15.9%), late attrition (11.4%), steady decliners (18.4%), early attrition (14.9%), and non-adherers (4.3%). On average, participants achieved 56% of their prescribed dose. Executive function and standing balance predicted adherence trajectory group membership. Poor executive function was associated with high initial adherence followed by a steep decline, while poorer balance was associated with more sustained adherence. Demographic or general health variables did not significantly predict adherence trajectories. Adherence to digital exercise is a dynamic behaviour, shaped by behavioural capability rather than by age or comorbidities. These findings inform the design of adaptive digital interventions to promote long-term adherence to digital programmes among older people.
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