JMIR Publications

ABSTRACT

Background:

Ambient Assisted Living (AAL) technologies are viewed as a promising way for prolonging aging in place, particularly when they are designed as closely as possible to the needs of the end users. However, very few evidence-based results are provided to support its real value, notably for frail older adults who have high risk of autonomy loss, as well as entering a nursing home.

Objective:

We mainly hypothesize that (1) the benefit from an AAL with a user-centered design is effective for aging in place of frail older adults in terms of everyday functioning (IADL score). Our secondary hypotheses are that (2) such an AAL decreases or neutralizes the frailty process and reduces the rates of institutionalization and hospitalization, and that (3) it improves psychosocial health of participants and their caregivers, when compared to control condition. We also assume that a large proportion of equipped participants will have satisfactory experience and will accept to subscribe to an internet connection for prolonging their participation to 12 additional months.

Methods:

HomeAssist (HA) is an AAL platform offering a large set of applications for three main age-related need domains (Activities of Daily Living, Safety and Social participation), relying on a basic set of entities (sensors, actuators, tablets...). The HA intervention involves monitoring based on assistive services to support the activities related to independent living at home. The study design is quasi-experimental with a duration of 12 months optionally extensible to 24 months. Follow-up assessments occurred at 0, 12 and 24 months. The primary outcomes measures are related to everyday functioning. Secondary outcomes measures include indices of frailty, cognitive functioning, and psychosocial health of participants and their caregivers. Every 6 months, user experience and attitudes towards HA are also collected from equipped participants. Concomitantly, HA usages will be collected. All measures of the study will be tested based on an intention-to-treat approach using a two-tailed level of significance set at alpha = .05, with respect to our primary and secondary efficacy outcomes.

Results:

Descriptive analyses were conducted to characterize the recruited equipped participants compared to the others (excluded and refusals) on the data available at the eligibility visit, to describe the characteristics of the recruited sample at baseline and also of the drop outs. Finally, the recruitment at 12 months included equipped participants (n=73), matched with non-equipped participants (n= 474, from preexisting cohorts). Results from this study will be disseminated via scientific publications and conferences. This will provide a solid basis for the creation of a startup to market the technology.

Conclusions:

This trial will inform the real-life efficacy of HA to prolong ageing in place for frail older adults, but also to yield informed analysis on AAL usages and adoption in frail older individuals.