methodology-for-establishing-community-wide-life-laboratory-for

Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data

An end-to-end suite of technologies has been established for the unobtrusive and continuous monitoring of health and activity changes occurring in the ...

Oregon Health & Science University

To understand the longitudinal relationship between loneliness and isolation.

Longitudinal Relationship Between Loneliness and Social Isolation in Older Adults: Results From the Cardiovascular Health Study.

Loneliness is a common condition in older adults and is associated with increased morbidity and mortality, decreased sleep quality, and increased risk of cognitive decline. Assessing loneliness in older adults is challenging due to the negative desirability biases associated with being lonely. Thus, it is necessary to develop more objective techniques to assess loneliness in older adults. In this paper, we describe a system to measure loneliness by assessing in-home behavior using wireless motion and contact sensors, phone monitors, and computer software as well as algorithms developed to assess key behaviors of interest. We then present results showing the accuracy of the system in detecting loneliness in a longitudinal study of 16 older adults who agreed to have the sensor platform installed in their own homes for up to 8 months. We show that loneliness is significantly associated with both time out-of-home ([Formula: see text] and [Formula: see text]) and number of computer sessions ([Formula: see text] and [Formula: see text]). [Formula: see text] for the model was 0.35. We also show the model's ability to predict out-of-sample loneliness, demonstrating that the correlation between true loneliness and predicted out-of-sample loneliness is 0.48. When compared with the University of California at Los Angeles loneliness score, the normalized mean absolute error of the predicted loneliness scores was 0.81 and the normalized root mean squared error was 0.91. These results represent first steps toward an unobtrusive, objective method for the prediction of loneliness among older adults, and mark the first time multiple objective behavioral measures that have been related to this key health outcome. 

A Smart-Home System to Unobtrusively and Continuously Assess Loneliness in Older Adults.

Interventions to slow cognitive decline typically can do little to reverse decline. Thus, early detection methods are critical. However, tools like cognitive testing are time consuming and require costly expertise. Changes in activities of daily living such as medication adherence may herald the onset of cognitive decline before clinical standards. Here, we determine the relationship between medication adherence and cognitive function in preclinical older adults. We objectively assessed medication adherence in 38 older adults (mean age 86.7 ± 6.9 years). Our results demonstrate that individuals with lower cognitive function have more spread in the timing of taking their medications ( = .014) and increase the spread in the timing of taking their medications over time ( = .012). These results demonstrate that continuous monitoring of medication adherence may provide the opportunity to identify patients experiencing slow cognitive decline in the earliest stages when pharmacologic or behavioral interventions may be most effective.

Variability in medication taking is associated with cognitive performance in nondemented older adults.

Alzheimer disease (AD) is a very challenging experience for all those affected. Unfortunately, detection of Alzheimer disease in its early stages when clinical treatments may be most effective is challenging, as the clinical evaluations are time-consuming and costly. Recent studies have demonstrated a close relationship between cognitive function and everyday behavior, an avenue of research that holds great promise for the early detection of cognitive decline. One area of behavior that changes with cognitive decline is language use. Multiple groups have demonstrated a close relationship between cognitive function and vocabulary size, verbal fluency, and semantic ability, using conventional in-person cognitive testing. An alternative to this approach which is inherently ecologically valid may be to take advantage of automated computer monitoring software to continually capture and analyze language use while on the computer.

Internet Searches and Their Relationship to Cognitive Function in Older Adults: Cross-Sectional Analysis.

Subtle changes in instrumental activities of daily living often accompany the onset of mild cognitive impairment (MCI) but are difficult to measure using conventional tests.

Weekly observations of online survey metadata obtained through home computer use allow for detection of changes in everyday cognition before transition to mild cognitive impairment.

Article	Year
Longitudinal Relationship Between Loneliness and Social Isolation in Older Adults: Results From the Cardiovascular Health Study. Journal of aging and health\| PubMed ID: 26491043	2016
A Smart-Home System to Unobtrusively and Continuously Assess Loneliness in Older Adults. IEEE journal of translational engineering in health and medicine\| PubMed ID: 27574577	2016
Variability in medication taking is associated with cognitive performance in nondemented older adults. Alzheimer's & dementia (Amsterdam, Netherlands)\| PubMed ID: 28349120	2017
Internet Searches and Their Relationship to Cognitive Function in Older Adults: Cross-Sectional Analysis. Journal of medical Internet research\| PubMed ID: 28877864	2017
Weekly observations of online survey metadata obtained through home computer use allow for detection of changes in everyday cognition before transition to mild cognitive impairment. Alzheimer's & dementia : the journal of the Alzheimer's Association\| PubMed ID: 29107052	2018

Johanna Austin

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