Monitoring Behaviors of Patients With Late-Stage Dementia Using Passive Environmental Sensing Approaches: A Case Series

Wan Tai M. Au-Yeung, Lyndsey Miller, Zachary Beattie, Rose May, Hailey V. Cray, Zachary Kabelac, Dina Katabi, Jeffrey Kaye, Ipsit V. Vahia

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To show the feasibility of using different unobtrusive activity-sensing technologies to provide objective behavioral markers of persons with dementia (PwD). Design: Monitored the behaviors of two PwD living in memory care unit using the Oregon Center for Aging & Technology (ORCATECH) platform, and the behaviors of two PwD living in assisted living facility using the Emerald device. Setting: A memory care unit in Portland, Oregon and an assisted living facility in Framingham, Massachusetts. Participants: A 63-year-old male with Alzheimer's disease (AD), and an 80-year-old female with frontotemporal dementia, both lived in a memory care unit in Portland, Oregon. An 89-year-old woman with a diagnosis of AD, and an 85-year-old woman with a diagnosis of major neurocognitive disorder, Alzheimer's type with behavioral symptoms, both resided at an assisted living facility in Framingham, Massachusetts. Measurements: These include: sleep quality measured by the bed pressure mat; number of transitions between spaces and dwell times in different spaces measured by the motion sensors; activity levels measured by the wearable actigraphy device; and couch usage and limb movements measured by the Emerald device. Results: Number of transitions between spaces can identify the patient's episodes of agitation; activity levels correlate well with the patient's excessive level of agitation and lack of movement when the patient received potentially inappropriate medication and neared the end of life; couch usage can detect the patient's increased level of apathy; and periodic limb movements can help detect risperidone-induced side effects. This is the first demonstration that the ORCATECH platform and the Emerald device can measure such activities. Conclusion: The use of technologies for monitoring behaviors of PwD can provide more objective and intensive measurements of PwD behaviors.

Original languageEnglish (US)
JournalAmerican Journal of Geriatric Psychiatry
DOIs
StateAccepted/In press - 2021

Keywords

  • agitation
  • Alzheimer's disease
  • apathy
  • behavioral and psychological symptoms
  • end-of-life
  • late-stage dementia
  • potentially inappropriate medication
  • technology
  • Unobtrusive activity-sensing technology

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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