Yeoh Lui Chen Xing, Yang Ningshan, Tang Arthur, Tam Wilson Wai San
Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore.
School of Science, Engineering and Technology, RMIT University, Ho Chi Minh City, Vietnam.
J Am Med Dir Assoc. 2025 Jan;26(1):105347. doi: 10.1016/j.jamda.2024.105347. Epub 2024 Nov 6.
To assess the effectiveness of smart home technologies (SHTs) in preventing and detecting falls among older adults in community and residential care settings.
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.
Residents of long-term residential settings ≥60 years of age.
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.
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.
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.
评估智能家居技术（SHTs）在社区和机构养老环境中预防和检测老年人跌倒方面的有效性。
对报告跌倒发生率、跌倒恐惧或住院结局的SHTs对照试验进行系统评价和荟萃分析。2023年8月，在6个学术数据库（PubMed、Cochrane、CINAHL、Scopus、Embase和IEEE Xplore）以及2个灰色文献数据库（ProQuest和ClinicalTrials.gov）中进行了检索。
年龄≥60岁的长期居住机构居民。
2023年8月在8个数据库中检索报告跌倒发生率、跌倒恐惧或住院结局的SHTs对照试验。两名评价者独立筛选研究、进行数据提取，并使用乔安娜·布里格斯研究所的批判性评价清单进行质量评估。使用RevMan Web进行荟萃分析。
通过数据库检索共获取12756项研究；去除重复项和不相关的标题/摘要后，对46篇全文进行了审查。总体而言，纳入了13项研究，共1941名参与者。其中2项被归类为低质量，5项为中等质量，6项为高质量。发现SHTs可显著降低跌倒发生率（相对风险，0.72；95%置信区间，0.57 - 0.93；z = 2.55；P = 0.01），但对跌倒恐惧没有显著影响（标准化均数差，0.19；95%置信区间， - 0.15至0.53；z = 1.11；P = 0.27），其对住院的影响尚无定论。
SHTs可能有助于降低社区和机构养老环境中老年人的跌倒发生率，提高安全性并支持其独立生活。未来研究应开展更多高质量研究并采用标准化结局测量方法。长期居住机构也可考虑采用SHTs进行跌倒预防和检测，以提高老年人的福祉。
