The Tril project aims to identify older people at risk of falls, memory loss and social isolation, writes Sylvia Thompson
FALLS, MEMORY loss and social isolation are the three main problems that lead to poor health in older people.
Now, a new research project aims to pick up on these problems at an early stage to help older people cope better in their own homes and prevent stressful and sometimes inappropriate hospitalisation.
"Forty-five per cent of the over-65s who come to the accident and emergency department do so because of a fall or a blackout," explains Prof Rose Anne Kenny, principal investigator of Technology Research for Independent Living (Tril) project and consultant in geriatric medicine at St James's Hospital, Dublin.
"Many of them then come into the hospital system and may never go back to normal living," she adds. The Tril project aims to identify older people at risk of falls, memory loss and social isolation and find ways to support them in their own homes so that they can continue to live independently.
The three-year project, based in St James's Hospital, has recruited 150 older people to date. The aim is to carry out detailed tests on up to 600 older people (400 of whom have had falls already and 200 of whom haven't) to identify early risk factors of age-related illnesses.
"The problem now is that people who live alone with not much social support can wait for hours or even days after a fall before they attend a hospital. At that stage, they can be acutely ill with unidentified fractures and acute kidney failure," says Dr Roman Romero-Ortuno, specialist registrar in geriatric medicine and researcher on the Tril project.
"That patient's prognosis is so much worse than it would have been if the problem had been picked up on through early assessment," he adds.
The participants on the Tril project will have full medical examinations including heart tracing (ECG), blood pressure measurement, vision and hearing tests, blood tests and walking tests.
The latter is carried out on a new so-called magic carpet which contains sensor-based hardware which collects information on balance and movement which is linked to software that clinicians can use to interpret and analyse the problems. For instance, it enables them to pick up on early signs of Parkinson's disease.
One long-term aim of the project is to fit such technology into carpet tiles in people's homes so that potential problems can be tracked over time. Another ambition is to encourage the development of new technologies, for example a small blood pressure monitor which could be easily used by older people in their homes.
"The unique aspect of this project is that we have an on-site medical skill base which can interpret what the technician sees which will allow the development of technologies that can be used in people's homes," says Kenny.
Such technologies will be tested in the homes of older people who participate in the project.
Another area that the Tril project will be looking at is psychological functioning. Participants will complete anxiety and depression assessments and complete tasks which test their attention, concentration and minor movements.
A decline in so-called cognitive function can result in people forgetting to take medication, having poor hygiene, low moods and loss of initiative.
"We are also interested in the interaction between social connection and physical and mental health," says Kenny.
"A recent Lancet study discovered that although a group of patients displayed similar levels of dementia in post-mortem brain scans, the patients who had good social engagement didn't show signs of dementia when they were alive while the patients who had 'painful loneliness', had Alzheimer's disease."
The researchers on the Tril project spend up to four hours assessing each older person who volunteers to be part of the study. They also refer patients on to appropriate specialists in the hospital if medical conditions are discovered.
"We have picked up clinical issues that need urgent attention in about 10 per cent of the older people we have assessed so far," explains Romero-Ortuno. "For example, we detected a heart murmur in one patient and sent her to the cardiologist and she has since had a successful angioplasty," he adds.
With 11 per cent of the population currently over 65 and projections that this figure will rise to 25 per cent by 2030, the significance of identifying older people at risk of illness is huge. "We hope that this research will inform policy decisions and have a beneficial effect on the services for older people in the future," says Kenny, who is also the chief investigator on the Longitudinal Study of Ageing at Trinity College Dublin.
Like to partake?
Researchers on the Technology Research for Independent Living (Tril) project are interested in hearing from people over 60 who would like to participate in the project.
To participate, you must be over 60 and living independently (either in your own home or in sheltered living accommodation). You must be able to give your informed consent to participate and be able to report in detail on various aspects of the assessment.
Those who feel socially isolated and who would benefit from a comprehensive geriatric assessment are particularly welcome. The full assessment takes between three and four hours to complete.
Tel: 01-4103863 or e-mail tril@stjames.ie.
See also www.trilcentre.org