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

被引:4
|
作者
Eost-Telling, Charlotte [1 ,2 ,3 ,6 ]
Yang, Yang [1 ,2 ]
Norman, Gill [2 ,3 ]
Hall, Alex [1 ,2 ]
Hanratty, Barbara [4 ]
Knapp, Martin [5 ]
Robinson, Louise
Todd, Chris [1 ,2 ,3 ]
机构
[1] Univ Manchester, Fac Biol Med & Hlth, Sch Hlth Sci, Natl Inst Hlth & Care Res NIHR,Older People & Frai, Manchester M13 9PL, England
[2] Univ Manchester, Sch Hlth Sci, Div Nursing Midwifery & Social Work, Manchester M13 9PT, England
[3] Univ Manchester, Fac Biol Med & Hlth, Sch Hlth Sci, Natl Inst Hlth & Care Res NIHR,,Appl Res Collabora, Manchester M13 9PL, England
[4] Newcastle Univ, Populat Hlth Sci Inst, Natl Inst Hlth & Care Res NIHR, Older People & Frailty Policy Res Unit, Newcastle Upon Tyne NE4 5PL, England
[5] London Sch Econ & Polit Sci, Natl Inst Hlth & Care Res NIHR, Care Policy & Evaluat Ctr, Older People & Frailty Policy Res Unit, London WC2A 2AE, England
[6] Univ Manchester, Jean McFarlane Bldg,Oxford Rd, Manchester M13 9PL, England
关键词
aged; dementia; falls; older people; rapid review; technology; OLDER-ADULTS; INTERVENTIONS; USABILITY; TAXONOMY; QUALITY; TRIALS;
D O I
10.1093/ageing/afad238
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Objective Falls are a common cause of potentially preventable death, disability and loss of independence with an annual estimated cost of 4.4bn pound. 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.
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页数:16
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