Long‐term digital device‐enabled monitoring of functional status: Implications for management of persons with Alzheimer's disease

Abstract

Introduction Informal caregiving is an essential element of health‐care delivery. Little data describes how caregivers structure care recipients’ lives and impact their functional status. Methods We performed observational studies of community dwelling persons with dementia (PWD) to measure functional status by simultaneous assessment of physical activity (PA) and lifespace (LS). We present data from two caregiver/care‐recipient dyads representing higher and average degrees of caregiver involvement. Results We acquired >42,800 (subject 1); >41,300 (subject 2) PA data points and >154,500 (subject 1); >119,700 (subject 2) LS data points over 15 months of near continuous observation. PA and LS patterns provided insights into the caregiver's role in structuring the PWD's day‐to‐day function and change in function over time. Discussion We show that device‐enabled functional monitoring (FM) can successfully gather and display data at resolutions required for dementia care studies. Objective quantification of individual caregiver/care‐recipient dyads provides opportunities to implement patient‐centered care.

GPS Tracking Technologies to Measure Mobility-Related Behaviors in Community-Dwelling Older Adults: A Systematic Review

“…Given that declining mobility signals functional deterioration, accurate evaluation of mobility in older adults should be a critical component of geriatric care. This suggests that for older adults facing functional declines, longitudinal GPS-enabled mobility monitoring can be a reliable and objective tool for early detection of changes before they impact the quality of life as documented in a previous report (Manley et al, 2020).…”

Relationship Between Life-Space Mobility and Health Characteristics in Older Adults Using Global Positioning System Watches

“…Nevertheless, GPS tracking is not affected by the limitations of self-reports, such as recall bias or reporting fatigue, our findings indicate the great potential of GPS tracking technology for continuous measurement of mobility and activities in everyday life particularly among older adults with memory deficit or cognitive impairment. That way, a GPS-based lifespace monitoring solution can be utilized to capture digital signals of physical and cognitive decline to inform predictions of adverse health outcomes (Giannouli et al, 2018;Harada et al, 2018;Manley et al, 2020). One of the innovative geospatial metrics we used is the size of the convex hull to estimate the geographic patterns (shape) and extent (size) of older adults.…”

Dementia caregiving across Latin America and the Caribbean and brain health diplomacy

“…Brain health diplomacy relies on different frameworks, including health diplomacy, science diplomacy, innovation diplomacy, and convergence science. 77 Compared with classic isolated approaches, brain health diplomacy can better coordinate multisectoral actions by developing integrated strategies that directly tackle the challenges of caregivers.…”

“… 75 , 76 Brain health diplomacy can bring translational support for dementia care management by use of scalable digital technology to reduce the costs and burden of dementia. 77 Massive data monitoring and caregiver dyad health assessments can help to identify unmet needs and monitor response to interventions. 77 However, maximising scalability requires coordinated actions at micro (individual), meso (community), and macro (national and transnational) levels via global policies to ensure improved outcomes.…”

“… 77 Massive data monitoring and caregiver dyad health assessments can help to identify unmet needs and monitor response to interventions. 77 However, maximising scalability requires coordinated actions at micro (individual), meso (community), and macro (national and transnational) levels via global policies to ensure improved outcomes. Brain health diplomacy should influence international diplomacy, not only at a local but mainly at a global level.…”