JMIR Publications

ABSTRACT

Background:

Dementia increases the risk of individuals getting lost due to cognitive decline, impacting daily functioning and heightening caregiver worry. Traditional search methods are often time–consuming and stressful, while GPS–based technologies face limitations like battery dependency. A novel crowdsourcing Internet of Things (IoT) technology using energy–efficient Bluetooth Low Energy (BLE) offers a potential solution to locate missing individuals with dementia more effectively by harnessing the power of the crowd and fostering a caring and inclusive community.

Objective:

This study aimed to evaluate the effectiveness of an BLE–based privacy–preserving crowdsourcing IoT system consisting of a novel BLE tag and an Android and iOS application in facilitating searches, reducing caregiver worry, and assessing usability among caregivers of individuals with dementia in Hong Kong.

Methods:

A single–arm, prospective observational study was conducted from November 2019 to October 2023. Caregivers (n=1,034) of individuals with dementia used an crowdsourcing IoT technology comprising a BLE tag, mobile application sensor, and location cloud server. Outcomes included search strategies, post–lost care arrangements, caregiver worry and distress (10–point scale), and usability (modified QUEST 2.0 survey). Data were collected at 6– and 12–month follow–ups and analysed using generalized estimating equations and linear mixed models.

Results:

Of 1,034 participants, 143 (13.8%) reported lost episodes, with 51 (35.7%) using BLE tags for searches. BLE tag users were more likely to adopt proactive search strategies (e.g., going out to search: adjusted odds ratio [AOR] 2.78, 95% CI 1.33,5.82, P=0.007) and preventative measures (e.g., IoT devices/CCTV: AOR 2.92, 95% CI 1.61,5.29, P<0.001). Worry about future loss decreased significantly over time (P=0.008), especially among BLE tag users (P=0.041), though retrieval time did not differ significantly. Usability satisfaction was high for design and data security, but only 43.7% were satisfied with accuracy.

Conclusions:

The BLE crowdsourcing system encourages proactive search behaviors and reduces caregiver worry, though accuracy depends on broader community adoption. Integration into dementia care plans could enhance safety and autonomy. Further research with a randomised controlled trial design is needed to confirm these findings.