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Background: Frailty is accompanied by limitations of activities of daily living (ADL) and frequently associated with reduced quality of life, institutionalization, and higher health care costs. Despite the importance of ADL performance for the consequence of frailty, movement analyses based on kinematic markers during the performance of complex upper extremity-based manual ADL tasks in frail elderly is still pending. The main objective of this study was to evaluate if ADL task performance of two different tasks in frail elderlies can be assessed by an activity measurement based on an acceleration sensor integrated into a smartwatch, and further to what degree kinematic parameters would be task independent., Methods: ADL data was obtained from twenty-seven elderly participants (mean age 81.6 ± 7.0 years) who performed two ADL tasks. Acceleration data of the dominant hand was collected using a smartwatch. Participants were split up in three groups, F (frail, n = 6), P (pre-frail, n = 13) and R (robust, n = 8) according to a frailty screening. A variety of kinematic measures were calculated from the vector product reflecting activity, agility, smoothness, energy, and intensity., Results: Measures of agility, smoothness, and intensity revealed significant differences between the groups (effect sizes combined over tasks η 2 p  = 0.18 - 0.26). Smoothness was particularly affected by frailty in the tea making task, while activity, agility, a different smoothness parameter and two intensity measures were related to frailty in the gardening task. Four of nine parameters revealed good reliability over both tasks (r = 0.44 - 0.69). Multiple linear regression for the data combined across tasks showed that only the variability of the magnitude of acceleration peaks (agility) contributed to the prediction of the frailty score (R 2  = 0.25)., Conclusion: The results demonstrate that ADL task performance can be assessed by smartwatch-based measures and further shows task-independent differences between the three levels of frailty. From the pattern of impaired and preserved performance parameters across the tested tasks, we concluded that in persons with frailty ADL performance was more impaired by physiological deficiencies, i.e., physical power and endurance, than by cognitive functioning or sensorimotor control., (© 2022. The Author(s).)

Background: Dementia of the Alzheimer's type can impair the performance of activities of daily living and therefore severely impact independent living. Assistive technologies can support such patients when carrying out daily tasks., Methods: In this crossover study, we used an augmented reality approach using a Microsoft HoloLens to support patients in a tea making task. During task execution, subjects received three-dimensional dynamic holograms of the sub-steps necessary to complete the task. Ten patients suffering from Alzheimer's disease were tested and post-hoc semi-structured interviews were conducted to assess usability., Results: The patients committed errors when executing the task with and without holographic assistance. No differences in success rates or error frequencies were observed (p success  = .250, p errors  = .887). Patients revealed prolonged trial durations (Glass' Δ = 1.475) when wearing the augmented reality headset. A model of multiple linear regression (R 2 adjusted  = .958) revealed an influence of the errors in the control condition and a moderation by the errors in the experimental condition. Patients with more severe problems in the natural performance of the task showed lower increases in trial durations when wearing the HoloLens., Conclusions: We assume that the application was a secondary task requesting its own resources and impairing performance on its own. The regression suggests however that the given assistance was compensating these additional costs in patients with stronger needs of support. Interview data on usability revealed an overall positive feedback towards the application although the hardware was considered uncomfortable and too large. We conclude that the approach proved feasible and the acceptability was overall high, although advances in hardware and the patient-interface are necessary to assist patients suffering from Alzheimer's disease in daily activities., Trial Registration: DRKS, DRKS00014870. Registered 11 June 2018 - Retrospectively registered, TrialID =  DRKS00014870 .

In this study, 26 young, 16 older adults ≤ 66a, and 22 older adults ≥ 67a were examined in a set of neuropsychological tests and the kinematics in two different activities of daily living (ADL) were assessed. Half of the participants performed the ADL in a natural speed, the other half as fast as possible. The performance in the Trail Making Task B revealed an increased slope after 67 years of age. When executed in a natural speed, ADL kinematics were comparable. When executed as fast as possible, almost all kinematic parameters showed significant group and speed differences and revealed group × speed interactions. Models of multiple linear regression predicting ADL trial durations showed similar strategies in the young and older adults < 67a. Factors were the general movement speed, the travelled path lengths, and the simultaneous use of both hands. In the older adults ≥ 67a, factors were the general movement speed, the travelled path length, and the activity level (during the task execution). A principal component analysis supported these findings by revealing two underlying components: movement strategy and age-dependent decline in primarily executive functions, where the ADL trial duration had comparable loadings on both components. These results in association with the accelerated decline in executive functions found in the oldest group suggest that deterioration of ADL with age is particularly caused by specific age-dependent changes in cognitive capacities.

The kinematic performance of basic motor tasks shows a clear decrease with advancing age. This study examined if the rules known from such tasks can be generalized to activities of daily living. We examined the end-effector kinematics of 13 young and 13 elderly participants in the multi-step activity of daily living of tea-making. Furthermore, we analyzed bimanual behavior and hand dominance in the task using different conditions of execution. The elderly sample took substantially longer to complete the activity (almost 50%) with longer trajectories compared with the young sample. Models of multiple linear regression revealed that the longer trajectories prolonged the trial duration in both groups, and while movement speed influenced the trial duration of young participants, phases of inactivity negatively affected how long the activity took the elderly subjects. No differences were found regarding bimanual performance or hand dominance. We assume that in self-paced activities of daily living, the age-dependent differences in the kinematics are more likely to be based on the higher cognitive demands of the task rather than on pure motor capability. Furthermore, it seems that not all of the rules known from basic motor tasks can be generalized to activities of daily living.

Abstract Background Frailty is accompanied by limitations of activities of daily living (ADL) and frequently associated with reduced quality of life, institutionalization, and higher health care costs. Despite the importance of ADL performance for the consequence of frailty, movement analyses based on kinematic markers during the performance of complex upper extremity-based manual ADL tasks in frail elderly is still pending. The main objective of this study was to evaluate if ADL task performance of two different tasks in frail elderlies can be assessed by an activity measurement based on an acceleration sensor integrated into a smartwatch, and further to what degree kinematic parameters would be task independent. Methods ADL data was obtained from twenty-seven elderly participants (mean age 81.6 ± 7.0 years) who performed two ADL tasks. Acceleration data of the dominant hand was collected using a smartwatch. Participants were split up in three groups, F (frail, n = 6), P (pre-frail, n = 13) and R (robust, n = 8) according to a frailty screening. A variety of kinematic measures were calculated from the vector product reflecting activity, agility, smoothness, energy, and intensity. Results Measures of agility, smoothness, and intensity revealed significant differences between the groups (effect sizes combined over tasks η2 p = 0.18 – 0.26). Smoothness was particularly affected by frailty in the tea making task, while activity, agility, a different smoothness parameter and two intensity measures were related to frailty in the gardening task. Four of nine parameters revealed good reliability over both tasks (r = 0.44 – 0.69). Multiple linear regression for the data combined across tasks showed that only the variability of the magnitude of acceleration peaks (agility) contributed to the prediction of the frailty score (R2 = 0.25). Conclusion The results demonstrate that ADL task performance can be assessed by smartwatch-based measures and further shows task-independent differences between the three levels of frailty. From the pattern of impaired and preserved performance parameters across the tested tasks, we concluded that in persons with frailty ADL performance was more impaired by physiological deficiencies, i.e., physical power and endurance, than by cognitive functioning or sensorimotor control.