Use of ICT for the assessment of dementia patients

Abstract

The European Commission project FP7 Dem@Care aspires to contribute to the timely diagnosis, assessment, maintenance, and promotion of self-independence for people with dementia by deepening the understanding of how the disease affects their everyday life and behavior. This project implements a multi-parametric, closed-loop, remote management program that affords adaptive feedback to the person with dementia, while at the same time including clinicians in the remote follow-up, enabling them to maintain a comprehensive view of the health status and progress of the affected person. Scientific objective: The presentation will include the objectives of the project in the research, development, and application of multi-parametric monitoring of daily activities, lifestyle, and behavior. Results will be presented for the multisensor assessment of daily living activity for patients with either Alzheimer's Disease (AD) or Mild Cognitive Impairment (MCI) and for elderly controls. Purpose: Assessment and care for AD and related disorders are becoming increasingly more complex and heterogeneous. None of the classical scale and staging systems fully capture the complexity of the disease. In this field, the use of Information and Communication Technologies (ICTs) is an innovative method for assessment and may represent a promising tool for professional as well as family caregivers. This paper describes the development of assessment methods to dectect behavioral changes and a decline in functionality. These methods consist of a multi-sensor system for automatic activity recogntion. The goal of this research is to provide clinicians a comprehensive image of a person's condition and illness progression. Method: Three groups consisting of 15 healthy elderly subjects, 15 MCI patients, and 15 AD patients were asked to carry out a 30-minute standardized scenario while being recorded with several video, audio, and movement sensors. The protocol included directed activities (execution of motor tasks), semidirected activities (execution of Instrumental Activities of Daily Living or IADLs), and undirected 'free' activities. Recorded data output of the different sensors were analyzed in order to determine relevant markers that predict decline in functionality measured objectively with the help of ICTs. Results & Discussion: Recordings of activity levels, execution of IADLs, and speech fluency capture the patients' functional and cognitive status with a high degree of accuracy 1,2,3. It has been shown that the data coming from the different sensors can provide meaningful additional information to clinicians for assessment and diagnosis purposes. Additionally, this new method may overcome former evaluation problems that result from biases and lack of reproducibility that are often present in clinical practice.