Ageing with Grace: How Smart Sensors Help Older Australians Thrive
In this thought piece, Research Hub for Connected Sensors for Health Deputy Director Professor Delbaere shares her perspective on how we can use smart sensing technologies to reduce falls and promote optimal ageing. Dr van Schooten, an emerging leader in the field of mobility and ageing, joins the conversation to discuss her ground-breaking research in the field.
Falls in older people are a growing public health issue worldwide, with one in three people aged 65 and over falling each year. A recent report by the Australian and New Zealand Falls Prevention Society shows that in 2020, 132,933 Australians were hospitalised and 5,034 died due to a fall. This means that today, 364 Australians aged 65 and over will have a fall that will put them in the hospital. By harnessing the power of wearable sensor technologies, we have the opportunity to empower people in managing their health, safely increasing their activity levels and enhancing their rehabilitation journey.
The ARC Research Hub for Connected Sensors for Health is a unique, collaborative effort between universities and industry organisations with a mission to develop and deploy connected sensors to the global market for the benefit of humanity. Our vision is to position Australia at the forefront of connected health by building an end-to-end ecosystem integrating sensor science, design, manufacturing, and commercialisation capabilities. Within the hub, we focus on the transformative potential of wearable sensor technology for optimal ageing.
Dr Kim van Schooten, a research fellow within the Hub, is evaluating how smart sensing technologies can reduce falls and promote active ageing. Her research is focused on wearable and ambient technology to identify mobility impairment and its underlying causes in ageing and disease. Sensor technology can also be used to accurately identify individuals at high risk for falls, allowing us to direct finite public health resources efficiently towards prevention. While several low-tech fall risk assessment tools are available, they have had limited integration into clinical practice due to concerns with accuracy and time.
Dr van Schooten demonstrated through her research that wearable sensing technology provides invaluable insights into an individual’s balance ability and mobility behaviour in their natural environment. Her studies have revealed a strong association between daily life walking and fall history, as well as future fall events (e.g. van Schooten et al., 2015). Predictive models utilising the amount and quality of daily life walking can identify individuals at risk of falls with high accuracy, enabling early intervention and prevention.
Furthermore, technology enables the delivery of personalised physical activity interventions to promote and maintain independence in daily life. An eHealth intervention called StandingTall, developed by Professor Delbaere and her team at Neuroscience Research Australia, has shown remarkable results in improving balance and preventing falls. StandingTall delivers a tailored balance exercise program that can be delivered in the home, with limited to no supervision by health professionals. While well-designed programs targeting balance, strength and task-specific exercises exist, the high cost and suboptimal delivery methods limit their effectiveness on a public health level.
This is even more pronounced in rehabilitation settings, a pivotal aspect of the recovery process following acute hospitalisation due to various health events. Regaining optimal daily function and mobility is a strong predictor of the ability to return to the community and a major contributor to health-related quality of life and independence, while a failure to regain function is associated with a higher rate of falls and mortality. Mobility is a cornerstone of well-being, influencing multiple aspects of healthy ageing. It empowers individuals to engage in physical activity, which benefits their body and mind. The ability to move independently and connect with others is crucial for mental health and emotional wellbeing, preserving a sense of self and identity as we age.
Smart sensor technologies can objectively monitor and track changes in mobility during rehabilitation, allowing health professionals to intervene promptly when progress does not align with expectations. We can even go further and monitor for abnormalities in physiological data such as weight gain, hypertension, hypotension and hyoxaemia, like we are doing with TCC Cardiac, a project led by Scientia Professor Nigel Lovell and Hub Theme Leader of Data and Applications and Associate Professor Sze-Yuan Ooi.
Remote sensing technology, together with telehealth, allows us to move rehabilitation from the hospital into the home situation. Commercially available technology, such as smartwatches and smartphones, can serve as a readily available tool for monitoring mobility as we undergo rehabilitation and age. Following on from this, these devices will be able to provide personalised solutions to restore mobility and prevent falls by guiding individuals to the most effective intervention at the right. It can serve as a springboard for the implementation of eHealth interventions, such as StandingTall, to promote safe mobility and prevent falls.
Our healthcare system is overburdened and under-resourced, and with the cost of healthcare steadily rising our current models of care are unsustainable. Rather than focusing on treating illnesses or conditions as they arise, we need a paradigm shift towards prevention and long-term management. Additionally, the funding model tends to reward healthcare providers for the number of services they provide, rather than the outcomes they achieve.
As Australia’s population is ageing, the pressure on the healthcare system intensifies. Technological advancements and digital health solutions hold the potential to transform the way we deliver healthcare. A more proactive, patient-centred, and coordinated approach to care is needed to put emphasis on prevention, early intervention, and self-management of health and accessing care. Digital health technologies have the potential to improve system efficiencies and patient outcomes, though the uptake in Australia has historically been slow.
Professor Kim Delbaere and Dr Kim van Schooten are leading the way to improve the health and well-being of our ageing population, reducing the financial burden of falls, and promoting healthy and active ageing on a larger scale. In collaboration with industry partners and academics within the Hub, we are working on an integrated model of secondary preventative care that delivers safe and effective care in an efficient, cost-effective manner.
This comprehensive solution will support patients in their transition from acute care to the community by delivering several vital components: a smartphone application for promoting health self-management, remote physiological monitoring coupled with an alert management system for early detection of clinical deterioration, a virtual tailored rehabilitation program deliverable in the comfort of one's home, a digital shared-care platform to coordinate patients' care journey and connect their care providers, a clinician dashboard offering vulnerability identification and clinical decision support, and an analysis-ready enriched data asset enabling real-time analysis of patient cohorts and facilitating pragmatic retrospective and prospective clinical studies. By establishing such a framework, we can implement effective digital interventions tailored to the unique needs of users, ultimately achieving our intended goals of improving patient outcomes and promoting optimal ageing.
If any of the solutions presented in this thought piece are relevant to your work and/or expertise, please email connectedsensors@unsw.edu.au to explore ways to get projects funded, partnered and launched through the NSSN and the ARC Research Hub for Connected Sensors for Health.
Professor Kim Delbaere is a Senior Principal Research Scientist at NeuRA and Director of Innovation & Translation at the Falls, Balance & Injury Research Centre, supported by the Australian NHMRC, and Professor at University of New South Wales, Sydney. Her research has contributed to the understanding of physical, psychological and cognitive factors causing falls. Her multidisciplinary approach incorporates elements from physiotherapy, psychology, brain imaging and software engineering towards preventing falls and promoting optimal ageing. Professor Delbaere has been successful at developing novel methods of applying technology to promote optimal ageing for over 10 years, in both healthy older people and a range of chronic diseases.
Dr Kim van Schooten is a research fellow at NeuRA and conjoint senior lecturer at UNSW supported by the Human Frontier Science Program. Her research focuses on using wearable and ambient technology to identify mobility impairment and its underlying causes in ageing and disease. Her goal is to provide personalised interventions to promote safe mobility and independence in daily life. Her pioneering research has led the way in using wearable sensors in daily life to assess balance and fall risk in older people, which is now being adopted by researchers world-wide. Dr van Schooten is currently working towards implementation of this transformative technique to monitor and enhance mobility as we age.
