Assessing the cognitive decline of people in the spectrum of AD by monitoring their activities of daily living in an IoT-enabled smart home environment: a cross-sectional pilot study

Margarita Grammatikopoulou; Ioulietta Lazarou; Vasilis Alepopoulos; Lampros Mpaltadoros; Vangelis P Oikonomou; Thanos G Stavropoulos; Spiros Nikolopoulos; Ioannis Kompatsiaris; Magda Tsolaki

doi:10.3389/fnagi.2024.1375131

Assessing the cognitive decline of people in the spectrum of AD by monitoring their activities of daily living in an IoT-enabled smart home environment: a cross-sectional pilot study

Front Aging Neurosci. 2024 Mar 28:16:1375131. doi: 10.3389/fnagi.2024.1375131. eCollection 2024.

Affiliations

¹ Information Technologies Institute, Centre for Research and Technology Hellas (CERTH-ITI), Thessaloniki, Greece.
² 1st Department of Neurology, G.H. "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki (AUTH), Thessaloniki, Greece.
³ Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece.
⁴ Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI - AUTh), Balkan Center, Buildings A & B, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Abstract

Introduction: Assessing functional decline related to activities of daily living (ADLs) is deemed significant for the early diagnosis of dementia. As current assessment methods for ADLs often lack the ability to capture subtle changes, technology-based approaches are perceived as advantageous. Specifically, digital biomarkers are emerging, offering a promising avenue for research, as they allow unobtrusive and objective monitoring.

Methods: A study was conducted with the involvement of 36 participants assigned to three known groups (Healthy Controls, participants with Subjective Cognitive Decline and participants with Mild Cognitive Impairment). Participants visited the CERTH-IT Smart Home, an environment that simulates a fully functional residence, and were asked to follow a protocol describing different ADL Tasks (namely Task 1 - Meal, Task 2 - Beverage and Task 3 - Snack Preparation). By utilizing data from fixed in-home sensors installed in the Smart Home, the identification of the performed Tasks and their derived features was explored through the developed CARL platform. Furthermore, differences between groups were investigated. Finally, overall feasibility and study satisfaction were evaluated.

Results: The composition of the ADLs was attainable, and differentiation among the HC group compared to the SCD and the MCI groups considering the feature "Activity Duration" in Task 1 - Meal Preparation was possible, while no difference could be noted between the SCD and the MCI groups.

Discussion: This ecologically valid study was determined as feasible, with participants expressing positive feedback. The findings additionally reinforce the interest and need to include people in preclinical stages of dementia in research to further evolve and develop clinically relevant digital biomarkers.

Keywords: Alzheimer’s disease; activities of daily living; healthy controls; mild cognitive impairment; sensor technology; smart home; subjective cognitive decline.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. The RADAR-AD project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement no 806999. This Joint Undertaking receives support from the European Union’s Horizon 2020 Research and Innovation Programme and EFPIA and Software AG. This communication reflects the views of the RADAR-AD consortium and neither IMI nor the European Union and EFPIA are liable for any use that may be made of the information contained herein. The funder played no role in study design, data collection, analysis and interpretation of data, or the writing of this manuscript.