Abstract
BackgroundEarly identification of frailty is crucial to prevent or reverse the syndrome but faces challenges due to frailty’s insidious onset. Monitoring behaviroal changes in real life may offer opportunities for early identifying frailty. Home-based technologies for assessing frailty have shown potentials. However, they are still in early stage of development with many types of technologies and behavioural and physical signs associated with frailty underexamined. This study presented a sensor-based system that used heterogeneous sensors and cloud technologies to monitor behavioural and physical signs of frailty from home settings. We aimed to validate the concurrent validity of the sensor system.MethodsThe sensor system consisted of motion, door, distance and mat sensors, a smart speaker, and a smart weight scale. The selection of these sensors was based on behavioural and physical signs found significantly associated with frailty. These signs included room-level physical activity, life space, sedentary behaviour, stair climbing, self-report exhaustion, and weight. Older adults’ voices were included in the system design. The sensor system prototype was tested in a simulated home lab environment with nine young, healthy participants. Cohen’s kappa and Bland-Altman Plot statistical methods evaluated the agreements between the sensor and ground truth measurements.ResultsExcellent concurrent validity was achieved for the smart speaker (100% agreement), the motion sensor (a kappa value of k=0.938), the door sensor (87.5% agreement, 100% if excluding outliers), the mat sensor (mean difference of -0.286, 95% limits of agreement) and the distance sensor (mean difference of 0.526, 95% limits of agreement). The smart weight scale and traditional weight scale had a significant difference in weight measurements. However, bivariate correlation showed a strong, positive correlation between the two measurements (r=0.942, n=24, p<0.001). ConclusionsOverall, FT is reliable for monitoring physical and behavioural signs of frailty in home settings. The ambient sensors and the smart speaker in FT showed excellent concurrent validity, while the smart weight scale needs further validation. This work laid the ground for the next step of the research to test the toolkit with frail and non-frail older adults to validate the system’s clinical effectiveness.