European Innovation Partnership on Active and Healthy Ageing From Plan to Action. Prevention of Falls
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1 European Innovation Partnership on Active and Healthy Ageing From Plan to Action Prevention of Falls Chris Todd Professor of Primary Care and Community Health University of Manchester Director
2 Masud, Morris Age & Ageing 2001; 30-S4 3-7 Rubenstein. Age & Ageing; 2006; 35-S2; ii % community dwelling >65yrs fall in year 40-60% no injury 30-50% minor injury 5-6% major injury (excluding fracture) 5% fractures 1% hip fractures Falls most serious frequent home accident 50% hospital admissions for injury due to fall History of falls a major predictor future fall
3 44 trials 9,603 participants Falls can be prevented! Exercise targets strength, balance, flexibility, endurance programmes with 2 or more components Supervised group exercise, Tai Chi, & individual prescribed at home Multi-factorial assessment & referral works under certain circumstances Appropriate medication review and withdrawal can reduce falls Environment Home safety only effective for high risk- professionally administered Surgery in appropriate clinical populations Cataract surgery, pacemakers (carotid sinus hypersensitivity) Vitamin D? Rate of falls (Rate Ratios) Group exercise: 0.78 [0.71, 0.86] Individual exercise 0.66 [0.53, 0.82] Group exercise: tai chi 0.63 [0.52, 0.78] Group exercise: gait, balance or functional training 0.73 [0.54, 0.98] Group exercise: strength/ resistance training 0.56 [0.19, 1.65] RR=0.83 (95%CI ) (High Dose & Challenging RR=0.58 (95%CI ) Sherrington et al JAGS 2008
4 Many EC Projects on Fall Prevention WIISEL Wireless Insole for Independent and Safe Elderly Living (FP7-ICT) FARSEEING FAll Repository for the design of Smart and self-adaptive Environments prolonging INdependent living (FP7-ICT) istoppfalls ICT based System to Predict & Prevent Falls (FP7-ICT) Giraff+ Combing social interaction and long term monitoring for promoting independent living (FP7-ICT) USEFIL Unobtrusive Smart Environments for Independent Living (FP7-ICT) SMILING Self Mobility Improvement in the elderly by counteracting falls (FP7-ICT) CONFIDENCE Ubiquitous Care System to Support Independent Living (FP7-ICT) SOFTCARE Plug and play home monitoring system (AAL) CARE Safe Private Homes for Elderly Persons (AAL) ROSETTA Guidance and Awareness Services for Independent Living (AAL) FATE Fall Detector for the Elder (CIP) I-DONT-FALL Integrated prevention & Detection solutions Tailored to the population & Risk Factors associated with FALLs (CIP) Caalyx-MV Complete Ambient Assisted Living, Market Validation (CIP) BIOTELEKINESY Communication platform for the tele-monitoring and the tele-management of the elderly to detect locomotion disabilities and prevent fall (FP7-People) STEADY ICT based holistic concept for fall prevention and management among the elderly community (FP7 People) V-TIME Virtual reality-treadmill combined Intervention for enhancing Mobility and reducing falls in the Elderly (FP7-Health) FallWatch A wearable miniaturized fall detection system for the elderly (FP7-SME) AMACS Automatic monitoring of Actitivies of Daily Living using Contactless Sensors (FP7 ERA-NET) ProFaNE Prevention of Falls Network Europe..and many more
5 Support European Innovation Partnership on Active and Healthy Ageing 1. Join up ongoing projects, networks, partnerships, and enterprises Thematic network under objective 3.4 Link with EAHC work to support EIP 2. Lots of ideas but little evidence! Collate evidence base for ICT solutions Work with ICT sector to implement clinical evidence based solutions 3. Disseminate best practice to change health European Silver Paper recommends provision of range of exercise opportunities Reviews reveal evidence based exercise regimens reduce falls Support creation of national programmes in falls prevention- Govt/public agencies, NGOs, providers, private sector, industry, commerce & users Make evidence based interventions widely available and fit for purpose Use ICT to disseminate evidence for fall prevention interventions both high risk and population shift strategies 4. Evaluate impact Need good data and data collection across Europe (Falls observatory)
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