Evaluation of an Automated Falls Detection Device in Nursing Home Residents - American Geriatric Society

Objectives

To determine the concordance between falls recorded using an investigational fall detection device and falls reported by nursing staff in a nursing home.

Design

Six-month prospective study.

Setting

Hebrew SeniorLife nursing home units in Boston, Massachusetts.

Participants

Nursing home residents with a documented history of at least one fall within 12 months before consent (N = 62, mean age 86.2 ± 8.1, 66% female).

Intervention

Subjects continuously wore an automated falls detection device on a pendant around their neck. The device contained triaxial accelerometers set to detect a rapid change in position that was interpreted as a fall.

Measurements

Healthcare staff reported daily falls, defined as unexpected events in which residents were found on the floor, and the number of these falls was compared with the number of falls recorded according to the device.

Results

Seven of 37 residents whom nursing staff found on the floor had a fall recorded according to the device (19%). The device did not identify any of the clinical fall events in 23 of the 37 fallers (62%). The device detected 17 of 89 total falls that nursing staff recorded (sensitivity 19%) within an 8-hour time window. Of 128 fall events that the device recorded, 17 were concordant with nursing reports (13%) within an 8-hour time window, and 111 (87%) were false positives.

Conclusion

There is poor concordance between falls recorded using the investigational fall detection device and falls to the floor that nursing home staff report.

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Driving Cessation and Health Outcomes in Older Adults - American Geriatric Society

Objectives

To determine what effect driving cessation may have on subsequent health and well-being in older adults.

Design

Systematic review of the evidence in the research literature on the consequences of driving cessation in older adults.

Setting

Community.

Participants

Drivers aged 55 and older.

Measurements

Studies pertinent to the health consequences of driving cessation were identified through a comprehensive search of bibliographic databases. Studies that presented quantitative data for drivers aged 55 and older; used a cross-sectional, cohort, or case–control design; and had a comparison group of current drivers were included in the review.

Results

Sixteen studies met the inclusion criteria. Driving cessation was reported to be associated with declines in general health and physical, social, and cognitive function and with greater risks of admission to long-term care facilities and mortality. A meta-analysis based on pooled data from five studies examining the association between driving cessation and depression revealed that driving cessation almost doubled the risk of depressive symptoms in older adults (summary odds ratio = 1.91, 95% confidence interval = 1.61–2.27).

Conclusion

Driving cessation in older adults appears to contribute to a variety of health problems, particularly depression. These adverse health consequences should be considered in making the decision to cease driving. Intervention programs ensuring mobility and social functions may be needed to mitigate the potential adverse effects of driving cessation on health and well-being in older adults.

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