Detection of activities of daily living impairment in Alzheimer's disease and mild cognitive impairment using information and communication technology

Abstract

BackgroundOne of the key clinical features of Alzheimer’s disease (AD) is impairment in daily functioning. Patients with mild cognitive impairment (MCI) also commonly have mild problems performing complex tasks. Information and communication technology (ICT), particularly techniques involving imaging and video processing, is of interest in order to improve assessment. The overall aim of this study is to demonstrate that it is possible using a video monitoring system to obtain a quantifiable assessment of instrumental activities of daily living (IADLs) in AD and in MCI.MethodsThe aim of the study is to propose a daily activity scenario (DAS) score that detects functional impairment using ICTs in AD and MCI compared with normal control group (NC). Sixty-four participants over 65 years old were included: 16 AD matched with 10 NC for protocol 1 (P1) and 19 MCI matched with 19 NC for protocol 2 (P2). Each participant was asked to undertake a set of daily tasks in the setting of a “smart home” equipped with two video cameras and everyday objects for use in activities of daily living (8 IADLs for P1 and 11 for P2, plus 4 temporal execution constraints). The DAS score was then computed from quantitative and qualitative parameters collected from video recordings.ResultsIn P1, the DAS score differentiated AD (DASAD,P1 = 0.47, 95% confidence interval [CI] 0.38–0.56) from NC (DASNC,P1 = 0.71, 95% CI 0.68–0.74). In P2, the DAS score differentiated MCI (DASMCI,P2 = 0.11, 95% CI 0.05–0.16) and NC (DASNC,P2 = 0.36, 95% CI 0.26–0.45).ConclusionIn conclusion, this study outlines the interest of a novel tool coming from the ICT world for the assessment of functional impairment in AD and MCI. The derived DAS scores provide a pragmatic, ecological, objective measurement which may improve the prediction of future dementia, be used as an outcome measurement in clinical trials and lead to earlier therapeutic intervention.

Instrumental Activities of Daily Living Performance and Role Satisfaction in People With and Without Mild Cognitive Impairment: A Pilot Project

“…Further contributing to problems with the diagnostic criteria, characterizations of IADL problems are limited by scope and by the tools used to measure IADL impairment (Sacco et al, 2012). Recent studies have looked at IADLs using tools that measure the prevalence of deficits within IADL tasks or that use gross indexes to characterize IADL deficits, such as no problems to severe problems (Bombin et al, 2012;De Vriendt et al, 2013).…”

The Potential Utility of Eye Movements in the Detection and Characterization of Everyday Functional Difficulties in Mild Cognitive Impairment

“…Schmitter-Edgecombe et al (2012) also found that MCI participants performed more poorly than healthy older adults on the Day-Out Task (DOT), a naturalistic test of functional ability that requires participants to complete multiple tasks and plan for an outing. Functional difficulties in MCI have also been revealed using Bsmart-home^technology in which participants were videotaped while performing daily activities in a room equipped with everyday objects (Sacco et al 2012). In one study, although individuals with MCI completed a performance-based test of IADLs with comparable accuracy to healthy older adults, their performance was significantly slower (Wadley et al 2008), suggesting reduced efficiency during everyday task completion.…”

Privacy Considerations when Designing Social Network Systems to Support Successful Ageing

“…Sacco et al [45] developed a Daily Activity Scenario (DAS) score, based on the Instrumental Activities of Daily Living questionnaire (IADL) that included watering plants, using a kettle, preparing a shopping list, using a telephone, watching TV and reading a newspaper. They demonstrated that such a scoring system could be used effectively in a smart home setting equipped with video monitoring to detect early functional impairment (although in their study there was relatively limited automatic recognition of IADL).…”