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Alzheimer's, Dementia & Mental Health
In-Home Motion Sensors Detect Dementia Signs in
Elderly
Study shows cognitive changes can be detected by
tracking daily activity
July 27, 2006 Motion and door sensors placed in
the homes of the elderly can help track activity patterns thought to
relate to memory changes that are early signs of dementia. The study
shows that continuous, unobtrusive monitoring of in-home activity may be
a reliable way of assessing changes in motor behaviors that may occur
along with changes in memory.
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Alzheimer's, Dementia & Mental Health |
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The Oregon Health & Science University study
results were presented last week at the 10th International Conference on
Alzheimer's Disease and Related Disorders in Madrid.
"To see a trend over time, you need multiple
measures - good days and bad days - and it often takes years to see that
trend in a clinic setting," said Tamara Hayes, Ph.D., assistant
professor of biomedical engineering at OHSU's OGI School of Science &
Engineering, and the study's lead author. She noted that most clinic
visits by elders are spaced over months or even years, and their memory
and motor skills performances are evaluated in a small number of tests
completed in a limited amount of time.
"In contrast, we're looking continuously at elders'
activity in their own homes," Hayes said. "Since we're measuring a
person's activity many times over a short period, we can understand
their normal variability and identify trends. If there's a change over a
period, you can see it quickly. "
Mild cognitive impairment is a known risk factor
for dementia, a neurological disorder most commonly caused by
Alzheimer's disease. Changes in clinical measures of activity, such as
walking and finger-tapping speeds, have been shown to occur at about the
same time as memory changes leading to dementia. By detecting subtle
activity changes over time in the natural setting of an elder's home,
researchers hope to more effectively identify when elders are starting
to have trouble.
Hayes and colleagues in the OHSU Oregon Center for
Aging & Technology - ORCATECH - used an unobtrusive "activity assessment
system" to continuously measure in-home walking speed and overall
activity of seven healthy elders and seven elders with mild cognitive
impairment. The sensors, which remained in the elders' apartments at a
Portland retirement community for up to 60 consecutive weeks, picked up
more than 108,000 hours of activity data.
Each system included wall-mounted motion sensors
placed in every room, door-mounted magnetic contact sensors, and
wireless transceivers that sent the data to a computer in the home. The
scientists then determined the number of times the sensors fired each
minute during 24-hour blocks of time to create an overall activity level
score for each participant.
Researchers found "the impaired subjects had more
variability in their walking times than the healthy elderly group," and
this variability was greater in the afternoon than in the morning,
according to the study. This is consistent with earlier studies
suggesting that variability in motor measures may predict later-onset
dementia.
In addition, the elders with mild cognitive
impairment were more variable in their activity during the day compared
to their healthy counterparts. This inconsistency was "the most striking
difference between the groups. Even with as few subjects as we had, the
groups were clearly separated by the variability of these measures,"
Hayes noted. Differences were detectable after only four weeks of
monitoring.
Such differences often are less obvious, if not
imperceptible, during a typical clinical examination. In fact, many
elders' desire to perform well during doctor visits make them walk
faster than their normal daily paces, masking changes that may be
clinically relevant, researchers say.
Hayes and her colleagues predict that as healthy
elders begin to develop cognitive impairment, they become more variable
day to day or even hour to hour, and that "this variability may provide
an early marker that can be used to predict the later onset of dementia
in a single individual." They have already begun a larger study to test
that theory.
Much of the hardware used in the study is simple,
widely available and inexpensive. Plus, it's getting smaller and
smaller, so it can be deployed in elders' homes much less obtrusively.
However, "the thing a lot of people don't realize is that although the
hardware appears to be the hard part, the data management is the hard
part," Hayes said. "Really, the bulk of our technology research is
focused on algorithm development" and the ability to mine and manage the
data these devices collect.
Study co-author Misha Pavel, Ph.D., professor of
biomedical engineering and computer science and electrical engineering
at OHSU's OGI School of Science & Engineering, says studies on systems
and technology such as those being developed by ORCATECH are "a critical
precursor of changing reactive health care to proactive care for
individuals."
A more proactive health care approach may be
essential to managing the rising cost of health care for aging baby
boomers. And "being able to stay at home and maintain independence
represents a significant improvement in quality of life of many elders
who like to remain as long as possible in their familiar environments,"
Pavel noted.
The ability to continuously and discretely collect
activity data over extended periods of time has given researchers a new,
more accurate way of "identifying clinical changes that are difficult to
get your arms around in the typically designed practice we have
nowadays," said ORCATECH's director, Jeffrey Kaye, M.D., OHSU professor
of neurology and biomedical engineering.
Notes:
ORCATECH is an interdisciplinary
center at OHSU established in 2004 as a National Institute on Aging
Roybal Center for Aging & Technology to study and develop technology
that assists in the assessment and remediation of elders in their home
environments. Its goal is to help elders retain independence by
discretely collecting data that may indicate health changes long before
quality of life is affected.
The study was funded by grants from
the National Institute on Aging and Intel Corp.
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