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

Authors

Myeounggon Lee
Ram Kinker Mishra
Anmol Momin
Nesreen El-Refaei
Amir Behzad Bagheri
Michele K York
Mark E Kunik
Marc Derhammer
Borna Fatehi
James Lim
Rylee Cole
Gregory Barchard
Ashkan Vaziri
Bijan Najafi

Publication Date

9-7-2022

Journal

Sensors

DOI

10.3390/s22186745

PMID

36146095

PMCID

PMC9501541

PubMedCentral® Posted Date

9-7-2022

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Activities of Daily Living, Aged, Cognition, Cognitive Dysfunction, Feasibility Studies, Humans, Neuropsychological Tests, remote patient monitoring, smart home, dementia, aging, Internet of Things (IOT), wearables, digital health, activity of daily living, life-space

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.