Stress may precede falls, and new technology may detect them

An older man who experiences a stressful life event, such as the death of a loved one or a serious financial problem, is significantly more likely to also experience one or more falls in the subsequent year, according to a new study. But if a fall occurs, technology under development separately may someday soon be able to detect it and send for help.

Howard A. Fink, MD, MPH, of the Veterans Affairs Medical Center in Minneapolis, was the first author of a study of 5,994 men aged more than 65 years who lived in the community and were enrolled in the Osteoporotic Fractures in Men study in six locations across the United States. Subsets of these men participated in additional visits or provided information about stressful events and falls that occurred in their lives.

Researchers found that, among men who reported stressful life events, falls occurred in 29.9 percent of cases where one type of stressful event had been reported, 35.5 percent of cases with two types of stressful events and 39.9 percent of cases where three or more types of stressful life events were reported. In age-adjusted analyses, any stressful life event was associated with a 41 percent increase in risk of fall and a nearly two-fold increase in risk for multiple falls in the following year.

The study “provides the strongest evidence to date supporting stressful life events as a risk factor for falls,” Fink says. Possible reasons for the association, investigators say:

  • Stressful events trigger a neurohormonal response, causing stress hormones to be released, leading to falls and other adverse health events.
  • Inflammation – a potential indicator of physical stress – could lead to a loss of muscle mass and impaired physical function.
  • Sudden emotions triggered by a stressful event could affect balance or visual attention, leading to a fall.

The findings are published in the journal Age and Ageing. Additional research could confirm the study’s results, explore underlying mechanisms and determine whether screening could reduce falls, Fink says.

NEW SENSOR SYSTEM

In the meantime, electrical engineers at the University of Utah have developed monitoring technology that can detect a person falling and, via a phone link to a service, could alert a caregiver or emergency service – without the need for a person to wear a monitoring device.

The fall detection system, developed by graduate student Brad Mager and Associate Professor Neal Patwari, PhD, uses sensors similar to those used in home wireless networks (see the image accompanying this article). They are placed around the perimeter of a room at two heights, corresponding to someone standing or lying down. Anyone standing – or falling – inside the network alters the path of signals sent between each pair of sensors; in this way, the technology can show the approximate location of a person in the room. The system also is programmed to differentiate between a dangerous fall and someone simply lying down on the floor.

The team’s study of the technology was funded by the National Science Foundation. The engineers plan to develop this proof-of-concept technology into a commercial product through Patwari’s startup company, Xandem Technology. Ultimately, they see it helping people live in their homes longer.

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