How wearable tech could cut fall risk for people with dementia

“Falls are one of the biggest issues with older adults […] but if you look at people living with dementia, the outcomes are even more tragic,” says Shelley Symonds, chief marketing officer at US tech company Clairvoyant Networks.  

As veterans of Silicon Valley and age care tech, Shelley and her team have spent years developing tech for older adults– including Theora Care, a purpose-built smartwatch that enables caregivers to monitor and communicate with loved ones at risk of wandering. Their new project, Theora 360, shifts the spotlight onto the catastrophic issue of falls among people living with dementia. 

Over the past year, they have been developing and testing the solution, with support from the Longitude Prize on Dementia. Last month they were one of five teams chosen as finalists. “It’s just such an honour,” Shelley says. “It’s given our whole team – not just our company but our research partner Texas A&M University [as well] – such a boost to keep up this work.”

Tackling a leading cause of death 

By focusing on falls, the project is tackling a leading cause of injury and death for adults aged 65 and over in the United States. Falls account for nearly 3 million emergency department visits annually among older adults in the US alone. Globally, older adults have the highest risk of serious injury or death from a fall, and, as the world’s population ages, this problem will only grow.  

“Those are some pretty horrifying statistics in and of themselves,” says Shelley. But people living with dementia, “are two or three times more likely to fall,” and three times more likely to experience serious injury and end up in hospital following a fall. People with dementia with a history of falling are also “five times more likely to be institutionalised following a fall” than people with dementia who do not fall. Hospitalisation, in turn, can speed up the onset of dementia symptoms. People with dementia are also more likely to under-report falls. Overall, the impact of all this on individuals, caregivers, health and social care systems, and society is dire.

“Extreme degree of precision” 

This is where Theora 360 comes in – wearable tech for people living with dementia with added Ultra Wideband (UWB), a new radar technology that offers highly precise positioning and tracking. UWB is already used across consumer sectors – to track ball movement in televised sports, for example – but Theora 360 is, Shelley believes, the first time it has been used to track fall risk for people living with dementia. “Think of it like an indoor radar,” Shelley explains. “It’s highly precise, down to three centimetres, so we can track motion, movement, mobility 24/7, with a neural network in the back end that processes that information.” A neural network is a machine learning system that processes data in a way that mimics the human brain, continuously spotting patterns and learning from its mistakes. 

The Clairvoyant Networks team sees Theora 360’s combination of AI, machine learning, and radar as a breakthrough opportunity to help detect falls and predict fall risk, enabling swift interventions and bringing peace of mind to caregivers. As well as detecting and providing data on falls that occur (negating the need to rely on people self-reporting falls, which can be highly unreliable), the solution monitors people’s movements – gait, stride, balance, and so on – and generates a fall risk score. Caregivers and families can observe where the risks are – “meaning there are eyes-on even when they’re not there.” 

For example, caregivers may notice that “when mum’s going up and down the stairs, it’s taking her longer, she’s less steady, she’s spending more time on both feet, something’s going on,” Shelley says. Equipped with this kind of information, people can take appropriate early action, such as changing medication, getting medical assessments, or rearranging the layout of a home – reducing the likelihood of injury and hospitalisation down the line. 

Testing the solution

This year, Clairvoyant Networks and Texas A&M University have been testing Theora 360 by tracking the mobility and movement of 12 people living with mild cognitive impairment. To assess the accuracy of their UWB fall detection system, they also turned to a cohort that is trained to fall – the Texas A&M judo team. They combined these findings with data from focus group discussions with people living with dementia and their caregivers. 

The results were highly positive, providing insights to take forward into the Finalist stage. “[People living with dementia and their caregivers] placed a really high value on what we’re trying to do, but of course had some improvements and suggestions,” Shelley says.  For example, they wanted to know what their fall risk prediction score means and what can they do about it: “The person living with dementia wants to know things such as: ‘If my score changes by 10%, what should I do about it? What caused it to change? Is this a temporary change, is this a permanent change?”

Expanding testing to 60 homes

These insights will inform a pilot due to run for one to years from early 2025. Theora 360 will be tested in 60 private homes in Texas, by people at different stages of dementia – “a broad spectrum that reflects the progression of the condition.” Working alongside Texas A&M University and assisted by US-based dementia organisations, the team will use rigorous research criteria to select a diverse range of people and households: “we definitely want to be getting a broad brush of folks, because dementia hits everyone,” and the greater the diversity, “the more you learn.”

“We should have some good results in the first year,” says Shelley. “We’re going to learn a heck of a lot […] about how far we can push this solution,” enabling the team to “take it from good to great.” 

Making the solution affordable to as many people as possible is another key focus. The Theora Care smartwatch is around US$250 rather than the $700-800 dollars that similar models cost, and they intend to keep prices down with Theora 360, too: “It’s always about the affordability because this condition does not know economics.”

The team are strongly motivated by broader issues of cost and value, as well. If you can avoid a fall, this has direct cost savings and impacts for healthcare systems, government budgets, and society at large, as well as for individuals, caregivers, and families, Shelley explains. With an ageing global population, the race to identify technologies that protect individuals and ease pressures will be crucial in years to come, as will putting in place systems to measure their impact and value. It’s a race Clairvoyant Networks is excited to pursue.