JMIR Publications

ABSTRACT

Background:

The use of assistive technologies (AT) to support older people has been fueled by the demographic change and technological progress in many countries. These devices are designed to assist seniors, enable independent living at home or in residential facilities, and improve quality of life by addressing age-related difficulties.

Objective:

We aimed to evaluate the effectiveness of AT on relevant outcomes with a focus on frail older adults.

Methods:

A systematic literature analysis of randomized controlled trials evaluating AT was performed according to the PRISMA guidelines. The databases Ovid Medline, PsycINFO, SocIndex, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), and IEEEXplore were searched from January 1st, 2009 to March 15th, 2019. AT were included when aiming to support the domains autonomy, communication, or safety of older people with a mean age ≥ 65 years . Trials conducted within a laboratory setting were excluded. Studies were retrospectively categorized for the physical frailty status of participants.

Results:

19 trials with a high level of heterogeneity were included in the analysis. Six device categories were identified: Mobility, personal disease management, medication, mental support, hearing, and vision. Eight trials showed significant effectiveness in all or some of the primary outcome measures. Personal disease management devices seem to be the most effective with four out of five studies showing significant improvement of disease related outcomes. Frailty could only be assessed for seven trials. Studies including significantly impaired or severely impaired participants showed no effectiveness.

Conclusions:

Different AT show some promising results in well-functioning but not in frail older adults, suggesting that the evaluated AT might not (yet) be suitable for this subgroup. The uncertainty of the effectiveness of AT and the lack of high-quality research for many promising supportive devices were confirmed in this systematic review. Large studies, also including frail older adults, and clear standards are needed in the future to guide professionals, older users, and their relatives. Clinical Trial: A protocol for this review has been published in the PROSPERO register under the registration number CRD42019130249.