Smart-Home Concept for Remote Monitoring of Instrumental Activities of Daily Living (IADL) in Older Adults with Cognitive Impairment: A Proof of Concept and Feasibility Study

Abstract

Assessment of instrumental activities of daily living (IADL) is essential for the diagnosis and staging of dementia. However, current IADL assessments are subjective and cannot be administered remotely. We proposed a smart-home design, called IADLSys, for remote monitoring of IADL. IADLSys consists of three major components: (1) wireless physical tags (pTAG) attached to objects of interest, (2) a pendant–sensor to monitor physical activities and detect interaction with pTAGs, and (3) an interactive tablet as a gateway to transfer data to a secured cloud. Four studies, including an exploratory clinical study with five older adults with clinically confirmed cognitive impairment, who used IADLSys for 24 h/7 days, were performed to confirm IADLSys feasibility, acceptability, adherence, and validity of detecting IADLs of interest and physical activity. Exploratory tests in two cases with severe and mild cognitive impairment, respectively, revealed that a case with severe cognitive impairment either overestimated or underestimated the frequency of performed IADLs, whereas self-reporting and objective IADL were comparable for the case with mild cognitive impairment. This feasibility and acceptability study may pave the way to implement the smart-home concept to remotely monitor IADL, which in turn may assist in providing personalized support to people with cognitive impairment, while tracking the decline in both physical and cognitive function.

Objective Assessment of Upper-Extremity Motor Functions in Spinocerebellar Ataxia Using Wearable Sensors

“…A reduced number of motor tasks may improve the feasibility of using the platform in a non-clinical setting and for remote patient monitoring. Digital health technologies are poised to become an integral part of modern health care, expedited by the surge in remote care necessitated by the COVID-19 pandemic [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. The proposed solution paves the way to integrating digital health technology (i.e., wearables) to enhance the utility of objective measures of ataxia.…”

A Semantic Framework to Detect Problems in Activities of Daily Living Monitored through Smart Home Sensors

“…Smart home technology, as proposed in a recent literature review, monitors both cognitive functions and ADLs in a simulated home environment [ 9 ], while the installed sensors can detect potential risks and enhance remote clinical assessment [ 10 ]. Therefore, adapting assistive technologies like smart homes to support independent living for people with dementia or early stages such as mild cognitive impairment (MCI), offering applications for memory aid, executive functions, social interactions, and more, constitutes a challenging recent approach [ 11 ]. Several research studies have so far been used to capture daily vital signs and automatically detect ADLs, enhance autonomy, recognize emergencies, and track the disease progression of individuals with cognitive impairment [ 12 , 13 , 14 ] through smart home systems.…”

Improving Wearable Solutions with Nudging Actions in the Chronic Care Management: The SENIOR Project

“…Moreover mental activities may protect against mild cognitive impairment. In fact engaging in mentally and physically stimulating activities, even late in life, may protect against new-onset mild cognitive impairment, according to different studies [1][2][3][4][5][6][7][8][9]. Particularly, an interesting study [1] found that cognitively normal people aged 70 years or older who engaged in computer use, craft activities, social activities, and playing games had a decreased risk of developing MCI.…”