Clinical Research Directory

Superiority of Intelligent Video Surveillance + Telealarm Over Telealarm Alone in Elderly People at Risk of Falling

Maintaining the elderly at home and preventing them from falling are major public health issues. The vast majority of elderly people wish to remain at home. The fear of a fall with prolonged standing is a frequent reason for institutionalization. There are few procedures that have been shown to be effective in preventing falls and their complications. Prolonged standing on the floor is a major complication that can lead to multiple events, including death. Tele-alarms are widely used in France and in Europe, but their effectiveness in the event of a fall is poor and their use is restrictive (they require physical and mental capacities to activate). However, elderly people at risk of falling are often frail or dependent, suffering from cognitive disorders and sometimes polymorbid, which explains the large number of failures of tele-alarms. There are other alert systems, notably intelligent video surveillance systems such as the VA2CS. This is a video system placed in the home that analyzes the position of subjects in real time using algorithms based on artificial intelligence. The system works continuously without video capture and sends an alert with a photo if a person is lying down after a fall. The alert is confirmed after an operator has checked the photo capture on a dedicated platform. To date, it has a sensitivity and specificity of over 90% (manufacturer's data not published). Its performance is equivalent to other intelligent video surveillance systems published in the literature. This system is autonomous and does not rely on the abilities of the person at risk of falling. Intelligent video surveillance is an innovative technology which has not yet been evaluated in a geriatric care program, nor compared to a reference or analyzed from a quality of life or medico-economic perspective. The hypothesis of this study is that intelligent video surveillance allows an exhaustive and early detection of the fall with a faster alert enabling to avoid prolonged standing on the ground and its consequences compared to the tele-alarm alone.

Home Support for Elderly: Evaluation of Intra- Extrinsic Determinants Which Maximize This Possibility

The French National Institute of Statistics and Economic Studies (INSEE) projects that the number of people aged 75 and over will increase in France from 5.2 million in 2007 to 11.6 million in 2060 (i.e., a 123% increase) and that of those aged 85 and over 1.3 to 5.4 million (315% increase). The marked increase in this segment of the population poses numerous practical and ethical questions regarding adaptation to our society, particularly in terms of medico-social offers. More specifically, surveys carried out among French people show an important paradox: almost 90% of those questioned want to be able to age in their home, but at the same time only a small part (estimated at 6%) of the French homes is adapted to the aging of its population. This inconsistency places the question of housing at the center of current public policies. If current societal concerns raise the question of need to find alternatives to entering an institution, a research work addressing all dimensions impacted by life at home for the elderly (quality of life, maintenance of functional, decision-making skills, nutritional status, etc.) jointly in the same population area and at different times (i.e., until leaving home for some people) remains to be carried out to allow us to better understand the nature and functioning of these factors, and thus propose integrated models. Indeed, too often these questions are studied separately on different populations and at different stages different from the life of the elderly person. Unfortunately, this does not allow us to clearly perceive the importance specificity takes on each factor, nor whether the proposals made really meet the objectives assigned to them. These questions relate in particular to: what aspects related to the person or their environment they contribute, when the person wishes, to be able to stay and live in your home? Since the departure of domicile would be postponed, does this mean that it is carried out due to the state health of the elderly worse? Understanding the relationship between the elderly and their housing will make it possible to draw up an inventory of the premises necessary for construction of the steps which will follow and which will be carried out by the different partners, in particular the public authorities, associations, social landlords (e.g., implementation of new clinical studies, health promotion, policy support, urban and housing planning, etc.). As part of an action-research program (concrete actions and transformative in the field), and relying on the approaches already underway, the main objective of this project will be to determine in elderly people living at home independent what are the main intrinsic factors and extrinsic elements that allow/promote this way of life.