A Systematic Review of Wearable Sensors and IoT-Based Monitoring Applications for Older Adults – a Focus on Ageing Population and Independent Living

Abstract Background Globally the population of older adults is increasing. It is estimated that by 2050 the number of adults over the age of 60 will represent over 21% of the world’s population. Frailty is a clinical condition associated with ageing resulting in an increase in adverse outcomes. It is considered the greatest challenge facing an ageing population affecting an estimated 16% of community-dwelling populations worldwide. Aim The aim of this systematic review is to explore how wearable sensors have been used to assess frailty in older adults. Method Electronic databases Medline, Science Direct, Scopus, and CINAHL were systematically searched March 2020 and November 2020. A search constraint of articles published in English, between January 2010 and November 2020 was applied. Papers included were primary observational studies involving; older adults aged > 60 years, used a wearable sensor to provide quantitative measurements of physical activity (PA) or mobility and a measure of frailty. Studies were excluded if they used non-wearable sensors for outcome measurement or outlined an algorithm or application development exclusively. The methodological quality of the selected studies was assessed using the Appraisal Tool for Cross-sectional Studies (AXIS). Results Twenty-nine studies examining the use of wearable sensors to assess and discriminate between stages of frailty in older adults were included. Thirteen different body-worn sensors were used in eight different body-locations. Participants were community-dwelling older adults. Studies were performed in home, laboratory or hospital settings. Postural transitions, number of steps, percentage of time in PA and intensity of PA together were the most frequently measured parameters followed closely by gait speed. All but one study demonstrated an association between PA and level of frailty. All reports of gait speed indicate correlation with frailty. Conclusions Wearable sensors have been successfully used to evaluate frailty in older adults. Further research is needed to identify a feasible, user-friendly device and body-location that can be used to identify signs of pre-frailty in community-dwelling older adults. This would facilitate early identification and targeted intervention to reduce the burden of frailty in an ageing population.

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THE TIPPING POINT STUDY: DIGITAL DETECTION AND DECISION SUPPORT FOR OLDER ADULTS AND FAMILIES

Innovation in Aging ◽

10.1093/geroni/igz038.2217 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S597-S597

Author(s):

Kimberly D Shea ◽

Kimberly D Shea

Keyword(s):

Older Adults ◽

Cultural Sensitivity ◽

Independent Living ◽

Mexican American ◽

Wearable Sensors ◽

Health And Safety ◽

The United States ◽

Census Bureau ◽

Tipping Point ◽

Safety Issues

Abstract In 10 years, the United States will experience a “dependency” ratio of one working age adult (20-64 years old) to one non-working person (> 65 or 85 years old will comprise 19 million of the non-working people (US Census Bureau, 2008). Busy working adults will have to be vigilant to determine when to make life-changing decisions about health and safety issues for people that depend on them. Older adults have gradual and cumulative physical and/or psychological aging changes or can experience significant events. Knowing when to make a life-changing decision, such as when to intervene with independent living due to safety risks, is difficult even when situations have constant vigilance. Eventually, older adults experience a seemingly abrupt, sudden and absolute point where a life changing decision must be made. This is the Tipping Point. Health data, derived from unobtrusive wearable sensors, are algorithmically synthesized to provide critical information on impending concerns via an electronic portal will help the busy working adult to predict and prevent the Tipping Point. This application of precision health care results in targeted and personalized education thus avoiding a potentially catastrophic Tipping Point. This symposium provides insight into five aspects of the Tipping Point: 1) significance of identification, 2) theoretical foundation for environmental and cultural sensitivity, 3) feasibility outcomes from a Mexican American population, 4) methodology for synthesizing quantitative metrics from multivariate streams of data, 5) creation of a culturally sensitive electronic portal to display predictive information and education about consequences

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Dynapaenic obesity and its association with health outcomes in older adult populations: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2018-027728 ◽

2019 ◽

Vol 9 (5) ◽

pp. e027728 ◽

Cited By ~ 2

Author(s):

Siobhan Leahy ◽

Marica Cassarino ◽

Matthew DL O' Connell ◽

Liam Glynn ◽

Rose Galvin

Keyword(s):

Systematic Review ◽

Older Adults ◽

Health Outcomes ◽

Older Adult ◽

Observational Studies ◽

Functional Disability ◽

Age Groups ◽

Ageing Population ◽

Cross Sectional ◽

Age Related

IntroductionTwo major global health challenges are the rapidly ageing population and the high prevalence of obesity in all age groups. Older adults are also susceptible to age-related loss of muscle strength, termed dynapaenia. The co-occurrence of both obesity and dynapaenia, termed dynapaenic obesity (DO), has been associated with poorer health outcomes and increased healthcare usage compared with either state alone. The purpose of this systematic review is to quantify the prevalence and incidence of DO in older adult populations, and to explore the association between DO and health outcomes, specifically chronic disease and multimorbidity, functional disability and healthcare usage.Methods and analysisUsing the Meta-analyses Of Observational Studies in Epidemiology guidelines, we will conduct a systematic review of cross-sectional and longitudinal observational studies of older adults, which include measures of DO and specified outcomes. Detailed literature searches of will be conducted using six electronic databases: Excerpta Medica dataBASE (EMBASE), PubMed, MEDLINE, SCOPUS, ScienceDirect and Cumulative Index of Nursing and Allied Health Complete (CINAHL), including articles published from database inception until Febuary 2019. The reference lists of included articles will also be searched. Two independent reviewers will undertake a three-step screening and review process using the Population, Risk Factor, Outcome framework to define eligibility. The Newcastle Ottawa Scale for non-randomised studies will be used to assess risk of bias and to rate study quality. The findings will be synthesised in a narrative summary, and a meta-analysis will be conducted where appropriate.Ethics and disseminationEthical approval is not required for this systematic review. Findings from this research will be submitted for peer-reviewed publication in academic journals, and presented at relevant academic conferences.PROSPERO registration numberCRD42018112471.

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A systematic review of the impacts of intergenerational engagement on older adults’ cognitive, social, and health outcomes.

10.31234/osf.io/g6qh8 ◽

2021 ◽

Author(s):

Anna Krzeczkowska ◽

David Spalding ◽

William J. McGeown ◽

Alan J. Gow ◽

Michelle Carlson ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Health Outcomes ◽

Randomised Controlled Trials ◽

Cognitive Outcomes ◽

Controlled Trials ◽

Ageing Population ◽

High Quality Research ◽

Age Attitudes ◽

Randomised Controlled

Background: Promoting older adults’ health and wellbeing via intergenerational engagement can help with the needs of an ageing population. This systematic review evaluated the impacts of intergenerational engagement on cognitive, social, and health outcomes in healthy older adults and older adults with mild cognitive impairment. Research Design and Methods: Comprehensive literature searches were undertaken, with records screened and filtered according to pre-registered criteria. Study quality was formally assessed, and a narrative synthesis produced from the extracted findings.Results: Forty-four studies were included in the review. Two out of five studies found significant intergenerational engagement effects on cognitive outcomes; 16 of 24 on social outcomes; and 21 of 30 on health-related outcomes. Only 11 studies fully met the criteria for high quality research, of which the majority (eight) focused on social outcomes.Discussion and Implications: This review has identified potential benefits of intergenerational engagement, most notably regarding anxiety, generativity, cross-age attitudes, and physical activity. However, only five included studies were randomised, controlled trials, therefore strong conclusions cannot yet be drawn. More research is required involving gold standard and comparable models, enabling wider implementation and generalisability, and randomised, controlled trials to provide the highest quality evidence.

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Enablers and barriers to the implementation of socially assistive humanoid robots in health and social care: a systematic review

BMJ Open ◽

10.1136/bmjopen-2019-033096 ◽

2020 ◽

Vol 10 (1) ◽

pp. e033096 ◽

Cited By ~ 6

Author(s):

Irena Papadopoulos ◽

Christina Koulouglioti ◽

Runa Lazzarino ◽

Sheila Ali

Keyword(s):

Systematic Review ◽

Older Adults ◽

Social Care ◽

Assessment Tool ◽

Humanoid Robots ◽

Current Evidence ◽

Ageing Population ◽

Technical Problems ◽

Age Related ◽

Health And Social Care

ObjectivesSocially assistive humanoid robots are considered a promising technology to tackle the challenges in health and social care posed by the growth of the ageing population. The purpose of our study was to explore the current evidence on barriers and enablers for the implementation of humanoid robots in health and social care.DesignSystematic review of studies entailing hands-on interactions with a humanoid robot.SettingFrom April 2018 to June 2018, databases were searched using a combination of the same search terms for articles published during the last decade. Data collection was conducted by using theRayyansoftware, a standardised predefined grid, and a risk of bias and a quality assessment tool.ParticipantsPost-experimental data were collected and analysed for a total of 420 participants. Participants comprised: older adults (n=307) aged ≥60 years, with no or some degree of age-related cognitive impairment, residing either in residential care facilities or at their home; care home staff (n=106); and informal caregivers (n=7).Primary outcomesIdentification of enablers and barriers to the implementation of socially assistive humanoid robots in health and social care, and consequent insights and impact. Future developments to inform further research.ResultsTwelve studies met the eligibility criteria and were included. None of the selected studies had an experimental design; hence overall quality was low, with high risks of biases. Several studies had no comparator, no baseline, small samples, and self-reported measures only. Within this limited evidence base, the enablers found were enjoyment, usability, personalisation and familiarisation. Barriers were related to technical problems, to the robots’ limited capabilities and the negative preconceptions towards the use of robots in healthcare. Factors which produced mixed results were the robot’s human-like attributes, previous experience with technology and views of formal and informal carers.ConclusionsThe available evidence related to implementation factors of socially assistive humanoid robots for older adults is limited, mainly focusing on aspects at individual level, and exploring acceptance of this technology. Investigation of elements linked to the environment, organisation, societal and cultural milieu, policy and legal framework is necessary.PROSPERO registration numberCRD42018092866.

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Smart home modification design strategies for ageing in place: a systematic review

Journal of Housing and the Built Environment ◽

10.1007/s10901-021-09888-z ◽

2021 ◽

Author(s):

Chuan Ma ◽

Olivia Guerra-Santin ◽

Masi Mohammadi

Keyword(s):

Systematic Review ◽

Older Adults ◽

Independent Living ◽

Smart Home ◽

Universal Design ◽

Design Strategies ◽

Ageing In Place ◽

Home Modification ◽

Hand Search ◽

Modification Process

AbstractThis research explores current strategies and approaches directed to integrate innovative technologies in the home modification process to support independent living and ageing in place. The systematic review considered studies conducted from the perspective of architecture, smart technology, and gerontology. Scientific databases of related disciplines (e.g. Scopus, Web of Science, Engineer village, Google Scholar, Crossref) were searched and supplemented by hand search method. Thirty-three out of 2594 articles were analysed from three perspectives: the framework of the smart home environment for ageing in place, the smart home modification process, and problems and countermeasures of independent living. The result shows that both home modification and smart technologies can support older adults’ independent living, especially with fall prevention and indoor accessibility. Technologies deployed in older adults’ homes are transiting from manual assistive technology to more intelligent devices, and the notion of the robotic home has emerged. According to existing practices, universal design is an extensively adopted strategy for smart home design and modification. However, in most cases, universal design is used as a retrofitting guideline for general home settings rather than specifically for smart homes. The fundamental requirements in smart home modification phases are customisation, minimum life interference, and extensible technologies to cope with the ageing process.

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Recognition of Bathroom Activities in Older Adults Using Wearable Sensors: A Systematic Review and Recommendations

Sensors ◽

10.3390/s21062176 ◽

2021 ◽

Vol 21 (6) ◽

pp. 2176

Author(s):

Yiyuan Zhang ◽

Ine D’Haeseleer ◽

José Coelho ◽

Vero Vanden Abeele ◽

Bart Vanrumste

Keyword(s):

Systematic Review ◽

Older Adults ◽

Activity Recognition ◽

Wearable Sensors ◽

Real Life ◽

Target Population ◽

Optimal Number ◽

Inclusion Criteria ◽

Quality Performance ◽

Future Studies

This article provides a systematic review of studies on recognising bathroom activities in older adults using wearable sensors. Bathroom activities are an important part of Activities of Daily Living (ADL). The performance on ADL activities is used to predict the ability of older adults to live independently. This paper aims to provide an overview of the studied bathroom activities, the wearable sensors used, different applied methodologies and the tested activity recognition techniques. Six databases were screened up to March 2020, based on four categories of keywords: older adults, activity recognition, bathroom activities and wearable sensors. In total, 4262 unique papers were found, of which only seven met the inclusion criteria. This small number shows that few studies have been conducted in this field. Therefore, in addition, this critical review resulted in several recommendations for future studies. In particular, we recommend to (1) study complex bathroom activities, including multiple movements; (2) recruit participants, especially the target population; (3) conduct both lab and real-life experiments; (4) investigate the optimal number and positions of wearable sensors; (5) choose a suitable annotation method; (6) investigate deep learning models; (7) evaluate the generality of classifiers; and (8) investigate both detection and quality performance of an activity.

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Sensor-based fall risk assessment in older adults with or without cognitive impairment: a systematic review

European Review of Aging and Physical Activity ◽

10.1186/s11556-021-00266-w ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Jelena Bezold ◽

Janina Krell-Roesch ◽

Tobias Eckert ◽

Darko Jekauc ◽

Alexander Woll

Keyword(s):

Systematic Review ◽

Older Adults ◽

Risk Assessment ◽

Cognitive Impairment ◽

Fall Risk ◽

Wearable Sensors ◽

Sensor Location ◽

Risk Of Falling ◽

Fall Risk Assessment ◽

Fall Risk Factors

Abstract Background Higher age and cognitive impairment are associated with a higher risk of falling. Wearable sensor technology may be useful in objectively assessing motor fall risk factors to improve physical exercise interventions for fall prevention. This systematic review aims at providing an updated overview of the current research on wearable sensors for fall risk assessment in older adults with or without cognitive impairment. Therefore, we addressed two specific research questions: 1) Can wearable sensors provide accurate data on motor performance that may be used to assess risk of falling, e.g., by distinguishing between faller and non-faller in a sample of older adults with or without cognitive impairment?; and 2) Which practical recommendations can be given for the application of sensor-based fall risk assessment in individuals with CI? A systematic literature search (July 2019, update July 2020) was conducted using PubMed, Scopus and Web of Science databases. Community-based studies or studies conducted in a geriatric setting that examine fall risk factors in older adults (aged ≥60 years) with or without cognitive impairment were included. Predefined inclusion criteria yielded 16 cross-sectional, 10 prospective and 2 studies with a mixed design. Results Overall, sensor-based data was mainly collected during walking tests in a lab setting. The main sensor location was the lower back to provide wearing comfort and avoid disturbance of participants. The most accurate fall risk classification model included data from sit-to-walk and walk-to-sit transitions collected over three days of daily life (mean accuracy = 88.0%). Nine out of 28 included studies revealed information about sensor use in older adults with possible cognitive impairment, but classification models performed slightly worse than those for older adults without cognitive impairment (mean accuracy = 79.0%). Conclusion Fall risk assessment using wearable sensors is feasible in older adults regardless of their cognitive status. Accuracy may vary depending on sensor location, sensor attachment and type of assessment chosen for the recording of sensor data. More research on the use of sensors for objective fall risk assessment in older adults is needed, particularly in older adults with cognitive impairment. Trial registration This systematic review is registered in PROSPERO (CRD42020171118).

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A Systematic Review of Robotics Research in Support of In-Home Care for Older Adults

Information ◽

10.3390/info11020075 ◽

2020 ◽

Vol 11 (2) ◽

pp. 75 ◽

Cited By ~ 1

Author(s):

Anas Abou Allaban ◽

Maozhen Wang ◽

Taşkın Padır

Keyword(s):

Systematic Review ◽

Older Adults ◽

Assisted Living ◽

Independent Living ◽

Ambient Assisted Living ◽

Physical Support ◽

The Social ◽

Support Tools ◽

Robotic Devices ◽

Meta Analyses

The aging population is growing at an unprecedented rate globally and robotics-enabled solutions are being developed to provide better independent living for older adults. In this study, we report the results from a systematic review of the state-of-the-art in home robotics research for caring for older adults. This review aims to address two questions: (1) What research is being done towards integrating robotics for caring for older adults? (2) What are the research and technology challenges that robots are facing in the home? Sixty-three papers have been identified and studied in this review by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Common themes that are consistent across the reviewed papers are distinguished and consolidated as follows: (1) Ambient assisted living, where smart home environments and physical support tools are studied; (2) Robot ecosystem, where robotic devices are used to provide various services; (3) Social interaction, where the social isolation problem has been targeted. We also summarize the results of similar literature reviews we came across during our search. The results of this study present the current research trends and technologies used in each category. The challenges and limitations of robotics applications are also identified. Suggestions for accelerating the deployment of robots at home for providing older adults with independent care in the home are presented based on the results and insights from this study.

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