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Falls is one of the three geriatric giants and is a significant causes of injury in the elderly. Approximately 28-35% of people aged 65+ fall increasing to 32-42% for those over 70 years of age experience a significant falls event. The frequency of falls increases with age and frailty level. Falls have a significant cost associated with the event. These costs can be assigned to two categories: Direct healthcare costs such as in-hospital treatments, medication, utilization of services such as rehabilitation etc. Indirect cost through societal impact e.g. loss of economic productivity by family members who must devout time caring for a faller. The WHO report on Falls reports  the average health system cost per single fall injury episode in the 65+ age group was $1049. Among the different costs, hospital inpatient services where the most significant costing accounting for more than 50% of the total overall costs.
The underlying risk factors in falls are varied and in many cases the these factors are inter-related.
Falls have a significant cost associated with the event. These costs can be assigned to two categories:
- Direct healthcare costs such as in-hospital treatments, medication, utilization of services such as rehabilitation etc.
- Indirect cost through societal impact e.g. loss of economic productivity by family members who must devout time caring for a faller.
The WHO report on Falls reports the average health system cost per single fall injury episode in the 65+ age group was $1049. Among the different costs, hospital inpatient services where the most significant costing accounting for more than 50% of the total overall costs. The average cost of hospitalization for falls related injury in the 65+ age group ranged from $6646 in Ireland to $17483 in the US. These costs are projected to increase to $US 240 billion. A recent Health Care Executive report into Falls in Ireland indicated that these falls injuries in older people is costing the Irish over €400 million per years. They stated that if current trends continue it is estimated that costs will escalate to €1billion by 2020. In addition to the direct costs, falls incur indirect costs that impact family members such as loss of productivity. The average cost in lost earnings has been estimated to be approximately €40k
Current sensing technologies are reactive i.e. indicate when a fall has occurred. Technology needs to evolve to point where the sensor is collecting information in a non contact fashion that can be used to determine a person risk of falling and trigger appropriate interventions before a fall event occurs.
Blythe et al  have shown that compliance for pendant type devices is less than < 20%.
Related Elderly Aspects
Falls can be related to specific aspects of the aging process or could also indicate a general deterioration of health. Please refer to aspects of aging for more details.
The majority of fall-related injuries of the elderly are mainly caused by slipping due to environmental factors rather than tripping, but most wearable fall detection devices are designed to capture dramatic falls. Falls detection devices fall into two broad categories, namely:
Body Worn Devices
Non Contact Sensing
Falls detections methods do little to eliminate the impact of a fall on an older person. At best falls detection systems reduce the response time to a falls event. There is growing interest in Falls prevention through Gait Assessments. These assessment are based on clinical assessment models or instrumental approaches which provide an emperical measure of Gait parameters.
In clinic settings various models have been developed to determine a patient risk of falling based on a battery of standard clinic tests. These include turning, bending, standing up from a chair, and walking. A wide range of clinical rating scales and functional test have now been evaluated in older people to determine their ability to predict falls. These include sit-to-stand ability turning, bending down, tandem walk and Performance Oriented Balance and Mobility Assessment (POMA).
- Performance Oriented Balance and Mobility Assessment (POMA)
- Berg Balance Scale (BBS)
- The Timed Up and Go Test
The benefit of these tests is that they require little or no expensive equipment and they are easy and quick to perform. However they can be subjective in they way the tests are administered and the results interpreted. Instrument tests can provided a more non subjective and empirically based approached to the assessment of gait and falls risks.
Gait Analysis Systems
Several studies have identified quantifiable gait markers that appear to distinguish between elderly "fallers" and non-fallers. These studies have relied on data acquired from specialised Gait Analysis systems.
The diffulties with these systems is that migration from a clinical laboratory setting in to a home setting to provide on-going monitoring of gait is not practical or cost effective.
It has been reported in the literature that exercise has a major role to play in preventing falls. Also the type of exercise is important as some types are likely to result in a greater reduction of falls risk.
Related Aspects of Ageing in CAPSIL:
Related Enabling Technologies in CAPSIL:
- ↑ http://www.who.int/ageing/publications/Falls_prevention7March.pdf
- ↑ http://www.hse.ie/eng/Campaigns/right/Preventing_Falls_and_Fractures.shortcut.html?showDoc=1
- ↑ M. A. Blythe, A. F. Monk and K. Doughty, Socially dependable design: The challenge of ageing populations for HCI Interacting with Computers, Vol 17, Issue 6, December 2005, pp 672-689