Falls management framework for supporting an independent lifestyle for older adults: a systematic review

Abstract

Falls are one of the common health and well-being issues among the older adults. Internet of things (IoT)-based health monitoring systems have been developed over the past two decades for improving healthcare services for older adults to support an independent lifestyle. This research systematically reviews technological applications related to falls detection and falls management. The systematic review was conducted in accordance to the preferred reporting items for systematic reviews and meta-analysis statement (PRISMA). Twenty-four studies out of 806 articles published between 2015 and 2017 were identified and included in this review. Selected studies were related to pre-fall and post-fall applications using motion sensors (10; 41.67%), environment sensors (10; 41.67%) and few studies used the combination of these types of sensors (4; 16.67%). As an outcome of this review, we postulated a falls management framework (FMF). FMF considered pre- and post-fall strategies to support older adults live independently. A part of this approach involved active analysis of sensor data with the aim of helping the older adults manage their risk of fall and stay safe in their home. FMF aimed to serve the researchers, developers, clinicians and policy makers with pre- and post-falls management strategies to enhance the older adults' independent living and well-being.

Are Wearable Devices Effective for Preventing and Detecting Falls: An Umbrella Review (A Review of Systematic Reviews)

“…These sensors typically use the data collected by the accelerometer or barometer and input them into an algorithm that decides whether a fall has occurred 12 . Once the device has decided that a fall is likely, current devices are usually designed so that this triggers an alert (phone call, text message, email) to a nominated person, caregiver or emergency service so that they can receive medical attention 13 . Apart from this alert-based falls detection approach, these types of sensors have also been used as part of falls risk assessments to help assess how at risk an individual is of falling so that effective, targeted interventions can be prescribed to that individual 14 .…”

“…Five reviews only included articles in which the full-text was available in English 13,15,25,27,29,30 . Montesinos et al included articles written in English, Italian, Spanish or French 30 .…”

“…Another systematic review reported a large range for sensitivity between 16.7-100% and a large range for speci city between 40-100% 27 . Three studies did not report sensitivity or speci city data 11,13,29 . Accuracy data were too heterogeneous and under-reported to comment on.…”

How Can We Develop an Efficient eHealth Service for Provision of Care for Elderly People with Balance Disorders and Risk of Falling? A Mixed Methods Study

“…Other researchers have evaluated the benefits of eHealth devices in balance training, reducing the risk of falling [ 29 , 30 , 31 ]. The eHealth services seem to have the potential to be a complementary method for preventive monitoring of falls, telerehabilitation, and monitoring of effective rehabilitation for elderly with balance disorder and risk of falling [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ], aligned with the eHealth definition: “ an emerging field in the intersection of medical informatics, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies. In a broader sense, the term characterizes not only a technical development, but also a state-of-mind, a way of thinking, an attitude, and a commitment for networked, global thinking, to improve health care locally, regionally, and worldwide by using information and communication technology ” [ 32 ].…”

“…However, in recent reviews [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ], it was pointed out that the clinical applicability of eHealth devices and services in screening, assessing and treating elderly people with balance disorders and the risk of falling in Portugal is still unknown. Therefore, we aim at studying how to obtain an efficient eHealth service for the provision of care for elderly people with balance disorders and the risk of falling.…”