Abstract:Falls are a leading cause of unintentional injuries and can result in devastating disabilities and fatalities when left undetected and not treated in time. Current detection methods have one or more of the following problems: frequent battery replacements, wearer discomfort, high costs, complicated setup, furniture occlusion, and intensive computation. In fact, all non-wearable methods fail to detect falls beyond ten meters. Here, we design a house-wide fall detection system capable of detecting stumbling, sli… Show more
“…A recent review on single and multiple sensorbased fall detection concluded wearable sensor-based solutions to be of accuracy to detect fall-events in older adults [25]. Nevertheless, fall detection systems using multiple input sources may lead to high costs and their use is often restricted to indoor locations [25,26]. Furthermore, fall detection systems may help to identify external fall risk (e.g., uneven ground) but they are limited in providing information about internal fall risk factors, e.g., dysfunctional patterns of gait or required motor tasks that are of interest to conceptualize fall prevention strategies.…”
Background
Higher age and cognitive impairment are associated with a higher risk of falling. Wearable sensor technology may be useful in objectively assessing motor fall risk factors to improve physical exercise interventions for fall prevention. This systematic review aims at providing an updated overview of the current research on wearable sensors for fall risk assessment in older adults with or without cognitive impairment. Therefore, we addressed two specific research questions: 1) Can wearable sensors provide accurate data on motor performance that may be used to assess risk of falling, e.g., by distinguishing between faller and non-faller in a sample of older adults with or without cognitive impairment?; and 2) Which practical recommendations can be given for the application of sensor-based fall risk assessment in individuals with CI? A systematic literature search (July 2019, update July 2020) was conducted using PubMed, Scopus and Web of Science databases. Community-based studies or studies conducted in a geriatric setting that examine fall risk factors in older adults (aged ≥60 years) with or without cognitive impairment were included. Predefined inclusion criteria yielded 16 cross-sectional, 10 prospective and 2 studies with a mixed design.
Results
Overall, sensor-based data was mainly collected during walking tests in a lab setting. The main sensor location was the lower back to provide wearing comfort and avoid disturbance of participants. The most accurate fall risk classification model included data from sit-to-walk and walk-to-sit transitions collected over three days of daily life (mean accuracy = 88.0%). Nine out of 28 included studies revealed information about sensor use in older adults with possible cognitive impairment, but classification models performed slightly worse than those for older adults without cognitive impairment (mean accuracy = 79.0%).
Conclusion
Fall risk assessment using wearable sensors is feasible in older adults regardless of their cognitive status. Accuracy may vary depending on sensor location, sensor attachment and type of assessment chosen for the recording of sensor data. More research on the use of sensors for objective fall risk assessment in older adults is needed, particularly in older adults with cognitive impairment.
Trial registration
This systematic review is registered in PROSPERO (CRD42020171118).
“…A recent review on single and multiple sensorbased fall detection concluded wearable sensor-based solutions to be of accuracy to detect fall-events in older adults [25]. Nevertheless, fall detection systems using multiple input sources may lead to high costs and their use is often restricted to indoor locations [25,26]. Furthermore, fall detection systems may help to identify external fall risk (e.g., uneven ground) but they are limited in providing information about internal fall risk factors, e.g., dysfunctional patterns of gait or required motor tasks that are of interest to conceptualize fall prevention strategies.…”
Background
Higher age and cognitive impairment are associated with a higher risk of falling. Wearable sensor technology may be useful in objectively assessing motor fall risk factors to improve physical exercise interventions for fall prevention. This systematic review aims at providing an updated overview of the current research on wearable sensors for fall risk assessment in older adults with or without cognitive impairment. Therefore, we addressed two specific research questions: 1) Can wearable sensors provide accurate data on motor performance that may be used to assess risk of falling, e.g., by distinguishing between faller and non-faller in a sample of older adults with or without cognitive impairment?; and 2) Which practical recommendations can be given for the application of sensor-based fall risk assessment in individuals with CI? A systematic literature search (July 2019, update July 2020) was conducted using PubMed, Scopus and Web of Science databases. Community-based studies or studies conducted in a geriatric setting that examine fall risk factors in older adults (aged ≥60 years) with or without cognitive impairment were included. Predefined inclusion criteria yielded 16 cross-sectional, 10 prospective and 2 studies with a mixed design.
Results
Overall, sensor-based data was mainly collected during walking tests in a lab setting. The main sensor location was the lower back to provide wearing comfort and avoid disturbance of participants. The most accurate fall risk classification model included data from sit-to-walk and walk-to-sit transitions collected over three days of daily life (mean accuracy = 88.0%). Nine out of 28 included studies revealed information about sensor use in older adults with possible cognitive impairment, but classification models performed slightly worse than those for older adults without cognitive impairment (mean accuracy = 79.0%).
Conclusion
Fall risk assessment using wearable sensors is feasible in older adults regardless of their cognitive status. Accuracy may vary depending on sensor location, sensor attachment and type of assessment chosen for the recording of sensor data. More research on the use of sensors for objective fall risk assessment in older adults is needed, particularly in older adults with cognitive impairment.
Trial registration
This systematic review is registered in PROSPERO (CRD42020171118).
“…In fact, lifelogging can help to raise awareness about one's own quality of life, thanks to the use of wearable trackers, ambient sensors, and even manual entry to collect suitable indicators [3]. The spectrum of the technological developments is extremely broad, reaching from video-based approaches [1,4,5], including those exploiting multiple cameras and suitable artificial intelligence-based processing aimed at fall detection, such as [6][7][8], over ambient systems based on different sensors and technologies (such as microphones, pressure or vibration sensors) [9,10] to wearable technologies using acceleration and rotation rate sensors [11][12][13]. All these technologies and systems have in common that they can be used to support people in their everyday life, e.g., by detecting emergency situations, by identifying typical movement and behavior patterns as well as anomalies, or by remembering functions [2,14].…”
Diverse sensor-based technologies can be used to track (older and frail) people’s movements and behaviors in order to detect anomalies and emergencies. Using several ambient sensors and integrating them into an assisting ambient system allows for the early identification of emergency situations and health-related changes. Typical examples are passive infrared sensors (PIR), humidity and temperature sensors (H&T) as well as magnetic sensors (MAG). So far, it is not known whether and to what extent these three specific sensor types are perceived and accepted differently by future users. Therefore, the present study analyzed the perception of benefits and barriers as well as acceptance of these specific sensor-based technologies using an online survey (reaching N=312 German participants). The results show technology-related differences, especially regarding the perception of benefits. Furthermore, the participants estimated the costs of these sensors to be higher than they are, but at the same time showed a relatively high willingness to pay for the implementation of sensor-based technologies in their home environment. The results enable the derivation of guidelines for both the technical development and the communication and information of assisting sensor-based technologies and systems.
“…These technologies can be classified into two types: (1) non-portable systems; (2) systems based on sensors and portable devices [ 32 ]. Non-portable systems use environmental sensors located in the monitoring area, typically artificial vision systems based on cameras [ 33 ] or floor sensors systems (pressure, vibration, capacitive, etc.) [ 34 ].…”
Frailty syndrome is an independent risk factor for serious health episodes, disability, hospitalization, falls, loss of mobility, and cardiovascular disease. Its high reversibility demands personalized interventions among which exercise programs are highly efficient to contribute to its delay. Information technology-based solutions to support frailty have been recently approached, but most of them are focused on assessment and not on intervention. This paper describes a sensor-based mHealth platform integrated in a service-based architecture inside the FRAIL project towards the remote monitoring and intervention of pre-frail and frail patients at home. The aim of this platform is constituting an efficient and scalable system for reducing both the impact of aging and the advance of frailty syndrome. Among the results of this work are: (1) the development of elderly-focused sensors and platform; (2) a technical validation process of the sensor devices and the mHealth platform with young adults; and (3) an assessment of usability and acceptability of the devices with a set of pre-frail and frail patients. After the promising results obtained, future steps of this work involve performing a clinical validation in order to quantify the impact of the platform on health outcomes of frail patients.
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