Digital technologies to prevent falls in people living with dementia or mild cognitive impairment: A rapid systematic overview of systematic reviews
What did we do?
We undertook a rapid review of reviews on the effectiveness of technology to reduce falls in people living with dementia or mild cognitive impairment. This review was undertaken in collaboration with the NIHR Older People and Frailty/Healthy Ageing Policy Research Unit (OPFPRU).
Why was this important?
Falls are one of the biggest causes of injury, disability and death, particularly among older people. As the number of older people in our population grows, falls are an ever-increasing problem causing harm and cost for society and health services.
People living with dementia are over twice as likely to fall as other older people, and their risk of being injured when they fall is also higher. Since they are more likely to fall they could gain benefit from anything that reduces their chance of falling. We increasingly use technology to support us in every aspect and at every stage of our lives and falls prevention in older age is no exception. Exergaming (technology-based exercise), virtual reality training, wearable technology and apps can all potentially help older people avoid falling, however research shows that older people are often excluded from studies of new technology, perhaps because of extra challenges they face in using some of it. We wanted to establish what evidence is currently available.
How did we do it?
We systematically reviewed the evidence on the use of technology for reducing falls in people with dementia or a milder type of impaired cognition. We included studies with people living in the community and residential or nursing homes but not those in hospital. We expected to find systematic reviews including studies of many different types of technology – our scope was broad and included sensors, mobile health including apps, wearable devices, telehealth and telemedicine, as well as types of computing platforms, connectivity, and software.
The review of reviews was registered on Open Science Framework (OSF) https://doi.org/10.17605/OSF.IO/M2CD8
What did we find?
We found:
- There was very limited evidence for the effectiveness of technology. Most of the primary studies included a small number of people with dementia, and there were problems with their methods and reporting. There were also issues with the systematic reviews that included these studies.
- There were no studies looking at apps and a lot of the technology was not being used to try to prevent people from falling. Environmental sensors were tested for preventing falls but the results were unclear. In one case carers found technology intrusive and disabled it during the study.
- More and better research on the use of technology for people with dementia is needed. Technology should be designed in collaboration with people with dementia and those who care for them – whether they are family carers or professionals. Developers also need to think about the whole system of care where their technology will be used.
- There is not currently enough evidence to identify which types of technology are best at preventing or reducing falls for older people living with dementia or mild cognitive impairment.
Who did we work with?
The NIHR Older People and Frailty/Healthy Ageing Policy Research Unit (OPFPRU).
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More information
Programme Manager
Gill Rizzello
gill.rizzello@manchester.ac.uk