Effectiveness Evaluation of Smart Home Technology in Preventing and Detecting Falls in Community and Residential Care Settings for Older Adults: A Systematic Review and Meta-Analysis.

OBJECTIVES

To assess the effectiveness of smart home technologies (SHTs) in preventing and detecting falls among older adults in community and residential care settings.

DESIGN

Systematic review and meta-analysis of controlled trials on SHTs, which reported fall incidence, fear of falling, or hospitalization outcomes, was conducted. Searches were conducted across 6 academic databases for scholarly articles (PubMed, Cochrane, CINAHL, Scopus, Embase, and IEEE Xplore) and 2 databases for gray literature (ProQuest and ClinicalTrials.gov) in August 2023.

SETTING AND PARTICIPANTS

Residents of long-term residential settings ≥60 years of age.

METHODS

Eight databases were searched in August 2023 for controlled trials on SHT which reported fall incidence, fear of falling, or hospitalization outcomes. Two reviewers independently screened for studies, performed data extraction, and performed quality assessment using the Joanna Briggs Institute critical appraisal checklists. The RevMan Web was used for meta-analysis.

RESULTS

A total of 12,756 studies were retrieved from the databases search; after removing duplicates and irrelevant title/abstracts, 46 full texts were examined. Overall, 13 studies comprising 1941 participants were included. Two were classified as low quality, 5 were classified as moderate quality, and 6 were classified as high quality. SHTs were found to significantly decrease fall incidences (relative risk, 0.72; 95% CI, 0.57-0.93; z = 2.55; P = .01) but have no significant impact in influencing the fear of falling (standardized mean difference, 0.19; 95% CI, -0.15 to 0.53; z = 1.11; P = .27), and their effect on hospitalization was inconclusive.

CONCLUSIONS AND IMPLICATIONS

SHTs may be beneficial in reducing fall incidence, enhancing the safety and supporting independent living among older adults in community and residential care settings. Future research should conduct more high-quality studies and use standardized outcome measurements. Long-term residential settings could also consider adopting SHTs for fall prevention and detection to enhance the well-being of older adults.