Digital care technologies in people with dementia living in long-term care facilities to prevent falls and manage behavioural and psychological symptoms of dementia: a systematic review.

Fall prevention and management of behavioural and psychological symptoms of dementia (BPSD) in long-term care (LTC) facility is a major challenge. The objective of this systematic review is to assess the evidence of digital technology in their management. All studies of English-language excluding ca...

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Publicado en:European Journal of Ageing Vol. 19; no. 3; pp. 309 - 324
Autores principales: Chan, Daniel Kam Yin, Chan, Luke Kar Man, Kuang, Ye Min, Le, Mai Nhat Vi, Celler, Branko
Formato: Artículo
Publicado: Springer Nature Sep2022
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2022
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      pub: Springer Nature
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        10.1007/s10433-021-00627-5
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        atl: Digital care technologies in people with dementia living in long-term care facilities to prevent falls and manage behavioural and psychological symptoms of dementia: a systematic review.
      aug:
        au:
          Chan, Daniel Kam Yin
          Chan, Luke Kar Man
          Kuang, Ye Min
          Le, Mai Nhat Vi
          Celler, Branko
        affil:
          University of New South Wales, 2052, Sydney, NSW, Australia
          Department of Aged Care and rehabilitation, Bankstown-Lidcombe Hospital, 2200, Bankstown, NSW, Australia
          Griffith University, 4215, Southport, QLD, Australia
      su:
        Behavior disorders
        Elder care
        Old age
        Treatment of dementia
        Psychology information storage & retrieval systems
        Medical information storage & retrieval systems
        Systematic reviews
        Digital technology
        Digital health
        Wearable technology
        Dementia patients
        Dementia
        Accidental falls
        Residential care
        MEDLINE
        Long-term health care
        Symptoms
      sug:
        subj:
          Behavior disorders
          Elder care
          Old age
          Continuing Care Retirement Communities
          Other Residential Care Facilities
          Treatment of dementia
          Psychology information storage & retrieval systems
          Medical information storage & retrieval systems
          Systematic reviews
          Digital technology
          Digital health
          Wearable technology
          Dementia patients
          Dementia
          Accidental falls
          Residential care
          MEDLINE
          Long-term health care
          Symptoms
      keyword:
        Behaviour
        Falls
        Long-term care
        Mood
        Behaviour
        Falls
        Long-term care
        Mood
      ab: Fall prevention and management of behavioural and psychological symptoms of dementia (BPSD) in long-term care (LTC) facility is a major challenge. The objective of this systematic review is to assess the evidence of digital technology in their management. All studies of English-language excluding case-reports were eligible for review. Databases chosen were MEDLINE, EMBASE, Scopus, Web of Science and PSYCINFO from January 2000 to June 2020. Downs and Black checklist was used to check for risk of bias. Papers with a focus in LTC setting, using digital technology as intervention for older adults with dementia, and with measurable outcomes (outcomes that are quantified, not descriptive) were included in the final review. Seventeen original papers (8 RCTs, 8 quasi-experimental and 1 mixed method) were included. Three articles examining position-sensor technology for fall prevention showed mixed results. Two showed no difference and 1 showed small reduction in fall after alarm removal but the positive effect might be due to bias. Overall, the sample sizes were too small to draw meaningful conclusion. Fourteen studies (9 pet robots of which 8 were robotic seal/PARO) were identified for BPSD and results were mixed. Overall, PARO might have modest benefit in BPSD compared to usual care but might be no better than plush toy with more hallucinations or delusions seen in advanced dementia. However, the significant heterogeneity in methodology (intervention intensity, lack of record in psychoactive drug use), clinical tools used (different BPSD scales, different digital technologies) and variability in outcomes made it difficult to draw clear-cut conclusion. Studies involving other digital technologies are scarce and in pilot phases; hence, conclusion is premature. One limitation of the review was that only 9 out of 17 studies were of good quality. The limited research work in position-sensors meant insufficient evidence to prove efficacy for their use in LTC setting. The possible modest benefit of PARO in BPSD (e.g. in agitation, apathy or reduction in psychoactive drugs) was off-set by possible adverse events such as delusions or hallucinations in advanced dementia.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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