Feasibility and Acceptability of a Technology-Mediated Fall Risk Prevention Intervention for Older Adults With Mild Cognitive Impairment.

George Demiris, Sean Harrison, Justine Sefcik, Marjorie Skubic, Therese S Richmond, Nancy A Hodgson
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Abstract

Background: Falls and fall-related injuries are significant public health issues for adults 65 years of age and older. The annual direct medical costs in the United States as a result of falls are estimated to exceed $50 billion, and this estimate does not include the indirect costs of disability, dependence, and decreased quality of life. This project targets community-dwelling older adults (OA) with mild cognitive impairment (MCI) who are socially vulnerable and thus at high risk for falling.

Methods: We have developed an innovative technology-supported nursing-driven intervention called Sense4Safety to (a) identify escalating risk for falls real time through in-home passive sensor monitoring (including depth sensors); (b) employ machine learning to inform individualized alerts for fall risk; and (c) link "at risk" socially vulnerable OA with a coach who guides them in implementing evidence-based individualized plans to reduce fall risk. The purpose of this study was to assess the feasibility and acceptability of the Sense4Safety intervention through participant interviews.

Results: We recruited a cohort of 11 low-income OA with MCI who received the intervention for 3 months. Our study findings indicate the overall feasibility of the intervention with most participants (n = 9; 82%) having confidence in the passive monitoring system to effectively predict fall risk and generate actionable and tailored information that informs educational and exercise components.

Conclusions: Passive sensing technologies can introduce acceptable platforms for fall prevention for community-dwelling OA with MCI.

技术介导的轻度认知障碍老年人跌倒风险预防干预的可行性和可接受性。
背景:跌倒和跌倒相关损伤是65岁及以上成年人的重要公共卫生问题。在美国,每年因跌倒导致的直接医疗费用估计超过500亿美元,这一估计不包括残疾、依赖和生活质量下降的间接费用。该项目针对社区居住的轻度认知障碍老年人(OA),他们是社会弱势群体,因此有很高的跌倒风险。方法:我们开发了一种创新的技术支持的护理驱动干预措施,称为Sense4Safety,通过家庭被动传感器监测(包括深度传感器)实时识别不断升级的跌倒风险;2)利用机器学习为跌倒风险提供个性化警报;3)将“有风险”的社会弱势老年人与教练联系起来,指导他们实施基于证据的个性化计划,以降低跌倒风险。本研究的目的是通过参与者访谈来评估Sense4Safety干预的可行性和可接受性。结果:我们招募了11名患有MCI的低收入OA患者,他们接受了3个月的干预。我们的研究结果表明,大多数参与者的干预总体上是可行的(n=9;82%)相信被动监测系统能够有效预测跌倒风险,并生成可操作的定制信息,为教育和锻炼内容提供信息。结论:被动传感技术可以为社区居住的MCI老年人提供可接受的跌倒预防平台。
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