Falls and fall-related injuries are significant public health issues for adults 65 years of age and older. Over a third of older adults (OA) fall each year and 10-20% of falls result in serious injuries such as fractures and head trauma. The annual direct medical costs in the US 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 OA with mild cognitive impairment (MCI). MCI is a leading risk factor for falls in OA. Approximately 15%-20% of OA have MCI, and over 60% of OA with MCI fall annually - two to three times the rate of those without cognitive impairment. We have developed and pilot-tested an innovative technology-supported intervention called Sense4Safety to 1) identify escalating risk for falls real-time through in-home passive sensor monitoring; 2) employ machine learning to inform individualized alerts for fall risk; and 3) link 'at risk' older adults with a coach who will guide them in implementing evidence-based individualized plans to reduce fall-risk. The purpose of this study is to assess the effectiveness of Sense4Safety in reducing fall risk with a randomized clinical trial, and understand implementation factors to improve the scalability of Sense4Safety in diverse community settings.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
200
Sense4Safety is a technology-enhanced intervention that includes multiple components: 1) in-home assessment; 2) tailored education and exercise; 3) passive monitoring and communication. The intervention is primarily via video-conferencing or phone, supplemented by in-home visits at intake, and 6 months to conduct in-person assessments.
University of Pennsylvania
Philadelphia, Pennsylvania, United States
Gait Speed
Usual gait speed (m/s)
Time frame: 0, 3 and 6 months
Lower extremity strength and functional mobility
Instrumented 30-second chair stand
Time frame: 0, 3, 6 mos.
Functional mobility and fall risk
Instrumented Timed Up \& Go (TUG) Test
Time frame: 0, 3, 6 mos.
Static balance in narrow stance positions
Instrumented 90-second balance test
Time frame: 0, 3, 6 mos.
Fear of Falling
measures the level of concern about falling during 16 social and physical activities inside and outside the home whether or not the person actually does the activity
Time frame: 0, 3, 6 mos.
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