Assessment of an automated telesurveillance system on serious falls prevention in an elderly suffering from dementia specialized care unit: The URCC GET-BETTER study (geriatric environmental telecare - behavioral engineering technology to enhance rehabilitation).

Abstract

Background: "Unités de réadaptation cognitivo-comportementale (URCC)" are specialized units for patients with Alzheimer's disease or related dementias presenting behavioral disorders. Falls are frequent in these settings, with dementia increasing fall risk six-fold. Detection remains difficult, especially at night when staff presence is reduced. Automated telesurveillance systems (ATS) may help improve fall detection and prevention.

Objective: To assess the impact of ATS on the prevention of serious nocturnal falls in URCC.

Methods: We conducted a prospective, multicenter, randomized clinical trial including 344 patients in the URCC units of Brive and Limoges. Patients in the intervention group were monitored with ATS, while controls stayed in rooms without ATS.

Results: Patients had a mean age of 83.6 years (SD = 6.1), with 58% women. The cumulative incidence of serious nocturnal falls was 0.01 (SD = 0.02) per patient per stay, with no difference between groups (U = 13,739; p = 0.262). For non-serious nocturnal falls, incidence was 0.03 (SD = 0.07) in the intervention group versus 0.01 (SD = 0.04) in control group (U = 15,391; p = 0.054). Total nocturnal falls were similar (0.03 versus 0.02; U = 14,684; p = 0.529).

Conclusions: ATS allowed detection of more non-serious nocturnal falls, potentially enabling tailored prevention strategies to reduce future falls. Further studies are needed to evaluate the effectiveness of these interventions.

Trial registration: ClinicalTrials.gov NCT01561872 (registered 13/02/2015).