A program called ‘Bingocize’ created by Western Kentucky University Associate Professor of Exercise Science Jason Crandall has received approval from the National Council on Aging for use in helping older adults prevent falls. Bingocize takes advantage of bingo's popularity with older adults to intergrate exercise and health education into the game.
Bingocize has been approved for inclusion in the Evidence-Based Falls Prevention Program of the U.S. Administration for Community Living. The approval received by WKU on Dec. 10 makes Bingocize eligible for funding under the Title III-D program of the Older Americans Act, which supports healthy lifestyles and promotes healthy behaviors for adults 60 and over.
While Bingocize studies have been done in more than 20 facilites, the program is currently being used in more than 70 locations across the U.S. The funding approval by the Administration for Community Living is expected to expand the use of the program in senior centers and other organizations that work with older adults.
WKU professors are currently conducting two major research projects on Bingocize. One project is related to "aging in place" by maintaining mobility and the other is being conducted in nursing homes.
“Everybody got your board ready?...alright…first number I-20…I-two-zero..”
Activities Assistant Michelle Cline calls out numbers at Greenwood Nursing and Rehabilitation Center in Bowling Green, Kentucky, as two dozen residents lean over their bingo cards.
This isn’t just any bingo game. This is Bingocize. So Cline calls out some directions that are not on the bingo card.
“…O-six-two.. Alright let’s do some marching.”
That’s right, Cline said “marching.” The residents, who are mostly in their 70s and 80s, begin stomping their feet under the table.
“…OK let’s point your toes…point them toes…”
Bingocize was created by Crandall in 2011 during the time he was a faculty member at Kentucky Wesleyan College in Owensboro.
“It came out of an effort to get my students more experience working with older adults. And I asked them to create an exercise program,” said Crandall. “They went to all the trouble to create the program and no one showed up.”
He said they had to figure out what happened with this first attempt to offer their exercise program at an independent living facility.
“The students were devastated, of course, because no one showed up to their program,” said Crandall. “And so as we were talking about it, we found out that everyone was down the hall playing bingo.”
That gave them an idea.
“We try to hide the exercise component as much as possible,” said Crandall. “We want to focus more on the positive – bingo - that they enjoy.”
Crandall said that was a game changer.
“When we added that fun component, we call it gamification, then they were interested and they showed up.”
Crandall is principal investigator on a Bingocize research project funded by a grant from the U.S. Center for Medicare and Medicaid Services. It studies the impact of Bingocize in dozens of nursing homes in Kentucky, especially on increasing socialization because that can encourage exercise.
For example, take 84-year-old Joyce Hinton at Greenwood Nursing Home.
“We have a very good time,” said Hinton. “We love to play bingo.”
Then there’s the exercise part.
“I don’t care for the exercises. It bothers me. I’d love to do it. I’m not doing this to aggravate everybody,” said Hinton. “It’s my just old age that’s got a hold of me and I can’t help it.”
Then she gets encouragement from Cline.
“Do what? I’m sorry.” “Do your tap dance.” “Tap dance?”
Hinton instantly responds with her feet.
The second project is a clinical trial funded by the National Institues of Health, Institute on Aging, to implement Bingocize at senior centers in Kentucky and Tennessee for older adults living independently. WKU Associate Professor of Psychological Sciences Matthew Shake is the principal investigator on that three-year project.
“So what we’re doing there is testing the effectiveness of the program not just for physical health, but also for improving cognitive health,” said Shake.
He said grants for the current larger projects are based on promising findings in earlier studies.
"Big breaks for us were getting funding from the Kentucky Science and Engineering Foundation, and also the Retirement Research Foundation, to do some smaller studies with some senior centers in the area," said Shake. "In those studies we did find improvements in a couple of aspects of physical functional performance, and also improvement in one aspect of cognition, something we call updating, which is the ability to update the current contents of your short-term memory."
Updating would be, for example, having a grocery list and remembering items to buy, and adding new items, while doing other things.
Crandall said, overall, several studies of Bingocize have shown statisically significant improvements in older adults in several categories, including an 18 percent increase in lower body strength, a 22 percent increase in upper body strength, a 14 percent increase in the cognitive ability of updating, and a 26 percent increase in knowledge of osteoarthritis and how to prevent falls.
The current three-year research project includes exercises for a relatively mobile population and looks at cognitive factors like reasoning and memory. Shake said using technology to slow cognitive decline is an essential part of the grant project, so the research team has developed an app for Bingocize and it’s played on tablets.
“What’s nice about the app is, it’s fully customizable, by us, remotely here at WKU,” said Shake. “So we might have senior centers throughout the region using the app at any given time, meanwhile, here back on campus, we can adjust, on the fly, the exercises, the health information, the types of bingo games they play.”
The Bingocize program is intellectual property owned by the WKU Research Foundation.
Professors at WKU are not alone in taking advantage of the value of the popular game of bingo as a framework for improving the quality of life and physical health of older adults.
Yi-Ling Hu is a doctoral candidate in occupational therapy at Washington University in St. Louis. She is on a research team with Professor of Occupational Therapy Susan Stark, whose specialized areas of interest include reducing the risk of falls and home modification interventions to support 'aging in place.'
At a November conference of the Gerontological Society of America, Hu said her research team has developed a program called 'Fall Prevention Bingo' that they are implementing with older adults in the community.
"Instead of shouting out a number, we shout out a key word," said Hu. "For example, if we draw a ball that has '4 medications' we say, 'Do you know that if you take more than four medications that's a fall risk?' "
Hu said that's because some medications make a person dizzy or have other side effects.
The once humble game of bingo is being used as a way to help older adults be healthier and more independent.
Bingo, it’s no longer just a game.
Note: This story was produced with the support of a journalism fellowship from the Gerontological Society of America, Journalists Network on Generations and the Silver Century Foundation.”