Technology Helping to Prevent Falls

By: Sheila Moorcroft

Embedded intelligence and sensors are set to revolutionise many aspects of healthcare and support for older people. Some of those technologies, which are wearable, ingestible, responsive and communicative, herald significant changes and benefits ahead, and could reduce the growing costs of falls among older people.

What is changing?

Currently, there are about 500 million people over 65 worldwide; by 2020 that will have risen to about 750 million. Approximately one in three people over the age of 65 experience a significant fall each year – many requiring hospital treatment – making a total of 250 million significant falls per year by 2020. New research is beginning to understand the different cost components of care associated with these falls: they are high and rising.

A new collaborative research programme in Europe, iStoppfalls, is examining the potential application of ICTs (Information and Communication Technologies) to enable more cost-effective and personalised fall prevention programmes which are easier to implement in people’s homes.

New ‘smart pills’ have been approved for use in Europe and the USA. The pills include a tiny sensor which can monitor the effects of the medication from the inside and transmit the information via a small wearable patch stuck on the user’s arm, to a mobile phone and on to relevant medical staff.

A stick-on sensor for bike helmets will automatically call a relevant group of contacts – including emergency services, in the event of an accident or fall.

Sensor technology is increasingly being used in sports to monitor movement and improve performance at professional levels. That technology is moving into new areas and is available in tennis rackets to monitor and improve strokes or on bikes to enhance performance.

Why is this important?

Falls have significant direct and indirect costs and effects. In 2000, in the USA alone the direct hospital costs of treatment for falls among this age group were estimated at $19 billion. Then there are the additional costs of increased hospital and other medical care in the years following a fall – directly and indirectly related to the fall; increased need for care at home or in a care establishment; reduced mobility and independence and increased depression, isolation and fear of falling- all of which are likely to bring additional health care needs and costs.

Better prevention as well as more rapid responses when falls do occur could radically reduce some of those costs and impacts. New technologies such as the ones discussed will begin to achieve that: they may improve understanding of whether a combination of medications is increasing the risk of falls by monitoring patients from the inside; ongoing monitoring of stability and movement patterns coupled with games could help understand the level and nature of risk of falls, encourage exercise and help maintain mobility, and perhaps even advise the wearer in real time; wearable alarms and intelligent surroundings could not only be used to monitor falls but also alert medical professionals and other contacts who need to know, automatically (rather than relying on the wearer to activate them) if there are indicators of increased risk of falls not just after the event.

Companies designing such technology will need to make it as unobtrusive, intuitive and as easy to use as possible. They will need to demonstrate its potential benefits to users and service providers alike to encourage uptake before significant falls start to occur. Health and social care providers will need to understand better the costs of falls in order to fund prevention programmes. Mobile phone companies will need to partner with other providers to enable low cost, easy to use apps and communications, but also reassure about privacy.

By Sheila Moorcroft