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Digital technologies to prevent falls in people living with dementia or mild cognitive impairment: A rapid systematic overview of systematic reviews

Lookup NU author(s): Dr Gill NormanORCiD, Professor Barbara HanrattyORCiD, Dr Louise Robinson

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2024 The Author(s). Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.Objective: Falls are a common cause of potentially preventable death, disability and loss of independence with an annual estimated cost of £4.4bn. People living with dementia (PlwD) or mild cognitive impairment (MCI) have an increased fall risk. This overview evaluates evidence for technologies aiming to reduce falls and fall risk for PlwD or MCI. Methods: In October 2022, we searched five databases for evidence syntheses. We used standard methods to rapidly screen, extract data, assess risk of bias and overlap, and synthesise the evidence for each technology type. Results: We included seven systematic reviews, incorporating 22 relevant primary studies with 1,412 unique participants. All reviews had critical flaws on AMSTAR-2: constituent primary studies were small, heterogeneous, mostly non-randomised and assessed as low or moderate quality. Technologies assessed were: wearable sensors, environmental sensor-based systems, exergaming, virtual reality systems. We found no evidence relating to apps. Review evidence for the direct impact on falls was available only from environmental sensors, and this was inconclusive. For wearables and virtual reality technologies there was evidence that technologies may differentiate PlwD who fell from those who did not; and for exergaming that balance may be improved. Conclusions: The evidence for technology to reduce falls and falls risk for PlwD and MCI is methodologically weak, based on small numbers of participants and often indirect. There is a need for higher-quality RCTs to provide robust evidence for effectiveness of fall prevention technologies. Such technologies should be designed with input from users and consideration of the wider implementation context.


Publication metadata

Author(s): Eost-Telling C, Yang Y, Norman G, Hall A, Hanratty B, Knapp M, Robinson L, Todd C

Publication type: Review

Publication status: Published

Journal: Age and Ageing

Year: 2024

Volume: 53

Issue: 1

Print publication date: 12/01/2024

Online publication date: 12/01/2024

Acceptance date: 06/12/2023

ISSN (print): 0002-0729

ISSN (electronic): 1468-2834

Publisher: Oxford University Press

URL: https://doi.org/10.1093/ageing/afad238

DOI: 10.1093/ageing/afad238

ePrints DOI: 10.57711/e3s7-3p87

PubMed id: 38219225

Data Access Statement: This is a review of previously published studies; therefore, all the data used in the review are already in the public domain. All data relevant to the included studies are included in the article or uploaded as supplementary information.


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