Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Oct 31, 2019
Date Accepted: Jan 26, 2020
Early Detection of Mild Cognitive Impairment with In-Home Sensors to Monitor Behaviour Patterns in Community Dwelling Seniors in Singapore: A Cross-Sectional Feasibility Study
ABSTRACT
Background:
Dementia is a global epidemic and incurs substantial burden to affected families and the health care system. A window of opportunity for intervention is the pre-dementia 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.
Objective:
In this cross sectional study, we aimed to establish the feasibility and acceptability of utilizing sensors in real homes of seniors to detect changes in behaviours unobtrusively.
Methods:
We recruited 59 community living elderly (aged ≥65 years who live alone) with and without MCI and observed them over 2 months. 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 normal cognition (HC). Frequencies of various sensor-derived behaviour 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 to HC. It was acceptable to over 80% of study participants with many requesting for permanent installation of the system.
Conclusions:
We demonstrated 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 real 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. Clinical Trial: NA
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