Mild Cognitive Impairment
Conditions
Keywords
fall prevention, mild cognitive impairment, exercise training
Brief summary
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.
Interventions
BEHAVIORALSense4Safety
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.
Sponsors
University of Pennsylvania
National Institute on Aging (NIA)
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* aged ≥ 65 years * reside in senior living communities and plan to be in the area for more than 6 months * be able to walk household distances * score of at least 1 of 12 on the Short Physical Performance Battery (SPPB) * meet MCI criteria (MCI is defined as a score ≥17 Montreal Cognitive Assessment)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Gait Speed | 0, 3 and 6 months | Usual gait speed (m/s) |
| Lower extremity strength and functional mobility | 0, 3, 6 mos. | Instrumented 30-second chair stand |
| Functional mobility and fall risk | 0, 3, 6 mos. | Instrumented Timed Up \& Go (TUG) Test |
| Static balance in narrow stance positions | 0, 3, 6 mos. | Instrumented 90-second balance test |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Fear of Falling | 0, 3, 6 mos. | 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 |
Countries
United States
Contacts
CONTACTSean Harrison, MPH
Outcome results
None listed