The technological frontier in fall management for older adults with dementia: A scoping review of prediction, detection, and prevention systems

Falls among older adults represent a major public health concern with substantial clinical, societal, and economic implications. People living with dementia (PlwD) are disproportionately affected, reflecting the combined impact of cognitive, motor, and pharmacological vulnerabilities. Traditional fall risk assessment tools have demonstrated limitations in capturing the complex, dynamic risk profiles of people living with dementia, highlighting the need for technological innovation in prediction, detection, and prevention. Despite advances in gerontechnology, evidence specific to dementia remains limited. To address this gap, a scoping review was conducted following PRISMA-ScR and Joanna Briggs Institute guidelines. Comprehensive searches across Scopus, Medline, Embase, APA PsycINFO, and CINAHL identified thirteen peer-reviewed studies (2015–2025) evaluating technology-based approaches for fall prediction, detection, or prevention among people living with dementia or populations used to model dementia-related functional impairments. Data were extracted and synthesized thematically by technological function. Thirteen studies met inclusion criteria, encompassing pressure-sensitive platforms, technology-enabled preventive interventions, wearable inertial measurement units, and ambient radar/vision-based systems, with the latter two most common. Sample sizes ranged from 3-309 participants with varying dementia severity. Wearables demonstrated strong fall detection performance in controlled laboratory settings but were limited by adherence challenges and reduced ecological validity. Ambient and radar-based systems demonstrated feasibility yet raised privacy and scalability concerns. Pressure-sensitive platforms showed promise for identifying pre-fall risk states but lacked clinical validation. Preventive interventions, including tablet-based exercise programs, demonstrated feasibility and preliminary evidence of reduced fall incidence. These technologies demonstrate promise for dementia care but require further validation, attention to usability, and consideration of ethical implementation before widespread adoption. Future work should emphasize dementia-specific trials, cost-effectiveness, and user-centered co-design to support sustainable implementation.