BACKGROUND:Dementia is a global epidemic and incurs substantial burden on the affected families and the health care system. A window of opportunity for intervention is the predementia stage known as mild cognitive impairment (MCI). Individuals often present to services late in the course of their disease and more needs to be done for early detection; sensor technology is a potential method for detection. OBJECTIVE:The aim of this cross-sectional study was to establish the feasibility and acceptability of utilizing sensors in the homes of senior citizens to detect changes in behaviors unobtrusively. METHODS:We recruited 59 community-dwelling seniors (aged >65 years who live alone) with and without MCI and observed them over the course of 2 months. The frequency of forgetfulness was monitored by tagging personal items and tracking missed doses of medication. Activities such as step count, time spent away from home, television use, sleep duration, and quality were tracked with passive infrared motion sensors, smart plugs, bed sensors, and a wearable activity band. Measures of cognition, depression, sleep, and social connectedness were also administered. RESULTS:Of the 49 participants who completed the study, 28 had MCI and 21 had healthy cognition (HC). Frequencies of various sensor-derived behavior metrics were computed and compared between MCI and HC groups. MCI participants were less active than their HC counterparts and had more sleep interruptions per night. MCI participants had forgotten their medications more times per month compared with HC participants. The sensor system was acceptable to over 80% (40/49) of study participants, with many requesting for permanent installation of the system. CONCLUSIONS:We demonstrated that it was both feasible and acceptable to set up these sensors in the community and unobtrusively collect data. Further studies evaluating such digital biomarkers in the homes in the community are needed to improve the ecological validity of sensor technology. We need to refine the system to yield more clinically impactful information.

译文

背景:痴呆症是一种全球流行病,给受影响的家庭和医疗保健系统带来沉重负担。干预的机会之窗是称为轻度认知障碍(MCI)的痴呆前期。个人往往在病情晚期才去看病,需要做更多工作以及早发现疾病;传感器技术是一种潜在的检测方法。
目的:这项横断面研究的目的是确定在老年人的家中使用传感器来毫不干扰地检测行为变化的可行性和可接受性。
方法:我们招募了59名有或没有MCI的社区居住的老年人(年龄在65岁以上的独居者),并在2个月的过程中对其进行了观察。通过标记个人物品并跟踪错过的药物剂量,可以监测健忘的频率。通过被动红外运动传感器,智能插头,床传感器和可穿戴活动腕带,可以跟踪诸如步数,出门在外的时间,看电视,睡眠时间和质量等活动。还对认知,抑郁,睡眠和社交联系进行了测量。
结果:完成研究的49位参与者中,有28位具有MCI,有21位具有健康认知(HC)。 MCI和HC组之间的各种传感器派生的行为指标的频率进行了计算和比较。 MCI参与者的活动不如HC参与者,每晚睡眠中断更多。与HC参与者相比,MCI参与者每月忘记服药的次数更多。超过80%(40/49)的研究参与者可以接受该传感器系统,其中许多要求永久安装该系统。
结论:我们证明在社区中设置这些传感器并毫不干扰地收集数据既可行又可接受。为了提高传感器技术的生态有效性,需要进一步研究评估社区家庭中的此类数字生物标志物。我们需要完善系统,以产生更具临床影响力的信息。

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