The influence of assistive technology and home modifications on falls in community-dwelling older adults: a systematic review protocol

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Abstract

Background

Fall-related injuries can reduce older adults’ independence and result in economic burdens. The assistive technologies and home modifications explored in this review are suggested to reduce the risk of falls of community-dwelling older people. However, the location of the in-home assistive technology being used, and the in-home modification likely interact and influence fall reduction and injury prevention of community-dwelling older adults. This interactive effect is poorly understood. A better understanding of the impact of assistive technologies and modifications in the homes of older adults is needed to support the appropriate application of these devices.

Objective

The objective of this systematic review is to detail the contribution of assistive technology and home modification on falls, fall frequency, fall severity, and fall location within the homes of community-dwelling older adults.

Methods

We will source articles from 3 databases (MEDLINE, CINAHL, Web of Science Core Collection) and will assess them using a set of pre-defined inclusion and exclusion criteria. Reporting will be in accordance with PRISMA 2020. Two independent reviewers will screen each study at the title and abstract and full-text level. We are managing citations within the Covidence software. Data extraction and analysis will be reported in a systematic review.

Discussion

The outcome variables of interest are fall frequency, fall location, injury, mortality, and hospitalization. These variables of interest all relate to falls, their severity, and their locations in the home. We are seeking a better understanding of how these outcomes vary with the use of different assistive technologies and home modifications as reported in the literature. This will help us understand where falls occur which may inform how different assistive technologies can be used by community-dwelling older adults to prevent falls and adverse outcomes in different areas of their homes. Our review will provide a basis for more intentional prescription of ambulatory assistive technologies and evidence-based recommendations of home modifications. It may also inform adaptations to existing technologies to foster safer mobility in the homes of community-dwelling older adults.

Systematic review registration

This protocol has been submitted for registration in PROSPERO CRD42022370172 on October 24, 2022.

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Most cited references 6

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RoB 2: a revised tool for assessing risk of bias in randomised trials

Jonathan A C Sterne, Jelena Savović, Matthew J L Page … (2022)

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ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions

Jonathan AC Sterne, Miguel A. Hernán, Barnaby Reeves … (2018)

Non-randomised studies of the effects of interventions are critical to many areas of healthcare evaluation, but their results may be biased. It is therefore important to understand and appraise their strengths and weaknesses. We developed ROBINS-I (“Risk Of Bias In Non-randomised Studies - of Interventions”), a new tool for evaluating risk of bias in estimates of the comparative effectiveness (harm or benefit) of interventions from studies that did not use randomisation to allocate units (individuals or clusters of individuals) to comparison groups. The tool will be particularly useful to those undertaking systematic reviews that include non-randomised studies.

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Global prevalence of falls in the older adults: a comprehensive systematic review and meta-analysis

Nader Salari, Niloofar Darvishi, Melika Ahmadipanah … (2022)

Background With increasing life expectancy, declining mortality, and birth rates, the world's geriatric population is increasing. Falls in the older people are one of the most common and serious problems. Injuries from falls can be fatal or non-fatal and physical or psychological, leading to a reduction in the ability to perform activities of daily living. The aim of this study was to determine the prevalence of falls in the older people through systematic review and meta-analysis. Methods In this systematic review and meta-analysis, the data from studies on the prevalence of falls in the older people in the world were extracted in the databases of Scopus, Web of Science (WoS), PubMed and Science Direct, and Google Scholar, Magiran and Scientific Information Database (SID) without any time limit until August 2020. To analyze the eligible studies, the stochastic effects model was used, and the heterogeneity of the studies with the I 2 index was investigated. Data analysis was conducted with Comprehensive Meta-Analysis software (Version 2). Results In the review of 104 studies with a total sample size of 36,740,590, the prevalence of falls in the older people of the world was 26.5% (95% CI 23.4–29.8%). The highest rate of prevalence of falls in the older people was related to Oceania with 34.4% (95% CI 29.2–40%) and America with 27.9% (95% CI 22.4–34.2%). The results of meta-regression indicated a decreasing trend in the prevalence of falls in the older people of the world by increasing the sample size and increasing the research year ( P < 0.05). Conclusion The problem of falls, as a common problem with harmful consequences, needs to be seriously considered by policymakers and health care providers to make appropriate plans for preventive interventions to reduce the rate of falls in the older people.

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Author and article information

Contributors

Jennifer M. Jakobi: jennifer.jakobi@ubc.ca

Journal

Journal ID (nlm-ta): Syst Rev

Journal ID (iso-abbrev): Syst Rev

Title: Systematic Reviews

Publisher: BioMed Central (London )

ISSN (Electronic): 2046-4053

Publication date (Electronic): 7 November 2023

Publication date PMC-release: 7 November 2023

Publication date Collection: 2023

Volume: 12

Electronic Location Identifier: 204

Affiliations

[1 ]GRID grid.17091.3e, ISNI 0000 0001 2288 9830, Aging in Place Research Cluster, , University of British Columbia Okanagan, ; 233-1147 Research Road (Arts Building), Kelowna, BC V1V 1V7 Canada

[2 ]School of Health & Exercise Sciences, University of British Columbia Okanagan, ( https://ror.org/03rmrcq20) Kelowna, BC Canada

[3 ]School of Engineering, University of British Columbia Okanagan, ( https://ror.org/03rmrcq20) Kelowna, BC Canada

[4 ]GRID grid.17091.3e, ISNI 0000 0001 2288 9830, Okanagan Library, University of British Columbia Okanagan, ; Kelowna, BC Canada

[5 ]GRID grid.17091.3e, ISNI 0000 0001 2288 9830, Centre for Chronic Disease Prevention and Management, , University of British Columbia Okanagan, ; Kelowna, BC Canada

[6 ]Department of Occupational Science and Occupational Therapy, University of British Columbia, ( https://ror.org/03rmrcq20) Vancouver, BC Canada

Article

Publisher ID: 2354

DOI: 10.1186/s13643-023-02354-7

PMC ID: 10629148

SO-VID: 96f7e8f0-e69a-401d-9347-8b6db1ab8ed5

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 28 October 2022

Date accepted : 20 September 2023

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100005247, University of British Columbia;

Custom metadata

ScienceOpen disciplines: Public health

Keywords: systematic review protocol,fall prevention,mobility aids,assistive technologies,aging,home modifications

Data availability:

ScienceOpen disciplines: Public health

Keywords: systematic review protocol, fall prevention, mobility aids, assistive technologies, aging, home modifications

The influence of assistive technology and home modifications on falls in community-dwelling older adults: a systematic review protocol

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Abstract

Background

Objective

Methods

Discussion

Systematic review registration

Related collections

Global Health Next Generation Network

Most cited references 6

RoB 2: a revised tool for assessing risk of bias in randomised trials

ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions

Global prevalence of falls in the older adults: a comprehensive systematic review and meta-analysis

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Contributors

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