Functional dementia assessment using a video monitoring system: Proof of concept

Abstract

Functional assessments of a person's ability to perform activities of daily living (ADL) currently involves clinical rating scales. These scales are limited in providing objective and sensitive information. Aim: To develop an automated tool for objective and quantitative assessment of functional ability in Alzheimer disease (AD). Methods: 16 patients with mild to moderate AD (age=76.7±4.0, MMSE=20,7±2.0) and 10 age and gender matched healthy controls (HC; age=73.9±4.5, MMSE=28.1±1.3) were evaluated clinically, cognitively, and functionally. Subsequently, each subject was asked to perform a set of daily tasks while monitored by two video cameras. A measure of functional impairment was then computed from quantitative and qualitative parameters collected from video recordings that were first annotated by two clinicians (blind to each other's results and the participants' clinical state). Results: The VMS (Video monitoring system) function index (derived from a ratio of efficacy in ADLs) correlated strongly with cognitive results (MMSE, Rho=0.81) as well as with IADL-E scores (Rho=-0.65). Conclusion: This study is a successful proof of concept for a novel assessment tool in dementia. The derived VMS function-index may provide a pragmatic, objective and continuous measure of cognitive and functional ability for clinical assessments as well as having a role as an outcome measure in clinical trials. Future research should complete the automation of the method.