The Apple Watch, ECG and fall detection–a trend too far?

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2018/10/apple-watch-series-4-elektrokardiogram.jpg” thumb_width=”125″ /]Mid-September’s Apple Fans kvelled about the Apple Watch Series 4 debut. Much was made in the health tech press of Apple’s rapid FDA clearance and the symbolism of their further moves into medical devices with the Series 4 addition of a built-in atrial fibrillation-detecting algorithm and an ECG, along with fall detection via the new accelerometer and gyroscope.

This latter feature is significant to our Readers, but judging from Apple’s marketing and the press, hardly an appealing Unique Selling Proposition to the Apple FanBoys’n’Girls who tend to be about 35 or wannabe. The website touts the ECG as a performance feature, a ‘guardian and guru’ topping all the activity, working out, and kickboxing you’re doing. It positions the fall detection and Emergency SOS in the context of safety during or after hard working out or an accident. It then calls 911 (cellular), notifies your emergency contacts, sends your current location, and displays your Medical ID badge on the screen for emergency personnel, which may not endear its users to fire and police departments. 

Laurie Orlov in her latest Age In Place Tech article points out the disconnect between the fall risk population of those aged 70+ and the disabled versus the actual propensity (and fisc) to buy an Apple Gizmo at $400+. PewInternet’s survey found that 46 percent of those over 65 actually own a smartphone, though this Editor believes that 1) much less than 50 percent are Apple and 2) most smartphone features beyond the basic remain a mystery to many. (Where store helpers, children, and grandchildren come in!)

Selling to older adults is obviously not the way that Apple is going, but there may be a subset of ‘young affluent old’ who want to sport an Apple Watch and also cover themselves for their cardiac or fall risk. (Or have children who buy it.) This is likely a sliver of a subset of the mobile PERS market, which is surprisingly small–only 20 percent of the total PERS market. But monitoring centers–doubtful, despite it being lucrative for GreatCall.

Fall risk in older adults may be higher during warm weather–indoors

A new study contradicts the accepted wisdom of ‘when’ and ‘where’. Fall risk for older adults peaks in the winter, with outdoor falls in the ice and snow. Wrong. A new study presented at the recent Anesthesiology 2017 meeting of the American Society of Anesthesiologists found that hip fractures peaked during the warmer months at 55 percent.

  • The leading months were May (10.5 percent), September (10.3 percent), and October (9.7 percent)
  • Over 76 percent of those fractures occurred indoors while tripping over an obstacle like throw rugs or falling out of bed
  • Outdoor fractures in warm months were led by trips over obstacles, with the second and third leading causes being struck by or falling from a vehicle (!) or falling on or down stairs

The study sampled 544 patients treated at The Hospital of Central Connecticut for hip fracture from 2013 to 2016, with warm months defined as May 1 through October 31. Study author Jason Guercio, MD, MBA concluded that “Given the results of this study, it appears that efforts to decrease fall risk among the elderly living in cold climates should not be preferentially aimed at preventing outdoor fractures in winter, but should focus on conditions present throughout the year, and most importantly on mitigating indoor risk.” For caregivers, another reason why hazards in walking areas have to be reviewed and minimized.

The information provided does not give any indication as to the patient activity when the accident happened. There was also no correlation with health conditions or time. For instance, other studies have pointed out that a person rising out of bed in the morning has a change of blood pressure (high and low), and in the middle of the night, that person may be half-asleep. 

Where does technology come in? Getting ahead of the curve via gait analytics to alert for changes in gait and difficulty in walking. Noticing those changes could lead to proactive care and prevention. But as of now, those systems are either in test (Xsens MVN BIOMECH, WiGait TTA 4 May, Carnegie-Mellon TTA 23 May 16, Tiger Place MU TTA 29 Aug 15) or in early days in assisted living (CarePredict)–which doesn’t much help older adults at home. ASA release, McKnight’s Senior Living

Gait and balance detector Kinesis QTUG successful in MS assessment study

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/01/QTUG.jpg” thumb_width=”150″ /]TRIL Centre (Dublin, Ireland) spinoff Kinesis, which developed the wearable sensor-based QTUG system for assessing fall risk through measuring gait and balance, was part of a recently presented study of relapsing remitting multiple sclerosis (MS) patients presented at the IEEE International Conference. The QTUG test was used in assessing patient mobility and fall risk over time. The base test, Timed Up and Go (TUG), is manually performed with a timer and observer; the patient rises from a chair, walks three meters, turns around, walks back and then sits back down again. Using this test, the Kinesis sensors reliably assessed the state of patient MS in 21 patients, using 32 of the 52 sensor parameters. In October, according to Mobihealthnews, Kinesis inked a deal with Intel-GE Care Innovations to distribute the system in the US; Intel and GE also are major funders of TRIL. IEEE Xplore abstract (full access on paid site).