Performance-based IADL evaluation of older adults with cognitive impairment within a smart home: A feasibility study

​Introduction
Mild cognitive impairment (MCI) is characterized by subtle deficits that functional assessment via informant-report measures may not detect. Sensors can potentially detect deficits in everyday functioning in MCI. This study aims to establish feasibility and acceptability of using sensors in a smart home for performance-based assessments of two instrumental activities of daily living (IADLs).

Methods
Thirty-five older adults (>65 years) performed two IADL tasks in a smart home laboratory equipped with sensors and a web camera. Participants' cognitive states were determined using published criteria including measures of global cognition and comprehensive neuropsychological test batteries. Selected subtasks of the IADL assessment were autonomously captured by the sensors. Total time taken for each task and subtask were computed. A point scoring system captured accuracy and number of attempts. Acceptability of the smart home setup was assessed.

Results
Participants with MCI (n = 21) took longer to complete both tasks than participants with healthy cognition (HC; n = 14), with significant time differences observed only in 'Cost calculation." Completion time for IADL tasks and scores correlated in the expected direction with global cogniton. Over 95% of the participants found the smart home assessment acceptable and a positive experience.

Discussion

We demonstrated the feasibility and acceptablity of the use of unobtrusive commercially available sensors in a smart home for facilitating parts of the objective assessment of IADL in older adults. Future studies need to identify more IADLs that are suitable for semi-auomated or automated assessments through the use of simple, low-cost sensors.

SOURCE:
Alzheimer's & Dementia: Translational Research & Clinical Interventions (TRCI)

DOI:
https://doi.org/10.1002/trc2.12152

AUTHOR(S):
Rawtaer I, Jabbar KA, Liu X, Ying TTH, Giang AT, Yap Lim Kiat P, Cheong CC, Tan HP, Lee P, Wee SL, Ng TP