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Modern sensor technology is increasingly used in older adults to not only provide additional safety but also to monitor health status, often by means of sensor derived digital measures or biomarkers. Social isolation is a known risk factor for late-life depression, and a potential component of social-isolation is the lack of home visits. Therefore, home visits may serve as a digital measure for social isolation and late-life depression. Late-life depression is a common mental and emotional disorder in the growing population of older adults. The disorder, if untreated, can significantly decrease quality of life and, amongst other effects, leads to increased mortality. Late-life depression often goes undiagnosed due to associated stigma and the incorrect assumption that it is a normal part of ageing. In this work, we propose a visit detection system that generalizes well to previously unseen apartments - which may differ largely in layout, sensor placement, and size from apartments found in the semi-annotated training dataset. We find that by using a self-training-based domain adaptation strategy, a robust system to extract home visit information can be built (ROC AUC = 0.773). We further show that the resulting visit information correlates well with the common geriatric depression scale screening tool (rho = -0.87, p = 0.001), providing further support for the idea of utilizing the extracted information as a potential digital measure or even as a digital biomarker to monitor the risk of late-life depression.

Background: Population aging is posing multiple social and economic challenges to society. One such challenge is the social and economic burden related to increased health care expenditure caused by early institutionalizations. The use of modern pervasive computing technology makes it possible to continuously monitor the health status of community-dwelling older adults at home. Early detection of health issues through these technologies may allow for reduced treatment costs and initiation of targeted preventive measures leading to better health outcomes. Sleep is a key factor when it comes to overall health and many health issues manifest themselves with associated sleep deteriorations. Sleep quality and sleep disorders such as sleep apnea syndrome have been extensively studied using various wearable devices at home or in the setting of sleep laboratories. However, little research has been conducted evaluating the potential of contactless and continuous sleep monitoring in detecting early signs of health problems in community-dwelling older adults., Objective: In this work we aim to evaluate which contactlessly measurable sleep parameter is best suited to monitor perceived and actual health status changes in older adults., Methods: We analyzed real-world longitudinal (up to 1 year) data from 37 community-dwelling older adults including more than 6000 nights of measured sleep. Sleep parameters were recorded by a pressure sensor placed beneath the mattress, and corresponding health status information was acquired through weekly questionnaires and reports by health care personnel. A total of 20 sleep parameters were analyzed, including common sleep metrics such as sleep efficiency, sleep onset delay, and sleep stages but also vital signs in the form of heart and breathing rate as well as movements in bed. Association with self-reported health, evaluated by EuroQol visual analog scale (EQ-VAS) ratings, were quantitatively evaluated using individual linear mixed-effects models. Translation to objective, real-world health incidents was investigated through manual retrospective case-by-case analysis., Results: Using EQ-VAS rating based self-reported perceived health, we identified body movements in bed & mdash;measured by the number toss-and-turn events & mdash;as the most predictive sleep parameter (t score=& ndash;0.435, P value [adj]=, Conclusions: Our results suggest that nightly body movements in bed could potentially be a highly relevant as well as easy to interpret and derive digital biomarker to monitor a wide range of health deteriorations in older adults. As such, it could help in detecting health deteriorations early on and provide timelier, more personalized, and precise treatment options., (JMIRMhealth Uhealth 2021;9(6):e24666) doi: 10.2196/24666

In recent years, consumer-grade sensors that measure health relevant physiological signals have become widely available and are increasingly used by consumers and researchers alike. While this allows for multiple novel, potentially highly beneficial, large-scale health monitoring applications, quality of these data streams is oftentimes suboptimal. This makes alignment of different high-frequency data streams from multiple, non-connected sensors, a difficult task. In this work we describe a noise-robust framework to align high-frequency signals from different sensors, that share some underlying characteristic, obtained in a free-living, non-clinical, home environment. We demonstrate the approach on the basis of a single-lead, medical-grade, mobile electrocardiography device and a consumer-grade sleep sensor that allows for ballistocardiography. Both commercially available sensors measure the physiological process of a heartbeat. We show, on the basis of real-world data with multiple people and sensors, that the two highly noisy and sometimes dissimilar signals could in most cases be aligned with considerable precision. As a result, we could reduce mean heartbeat peak-to-peak difference by 58.1% on average and increase signal correlation by 0.40 on average.

Background: Home monitoring sensor systems are increasingly used to monitor seniors in their apartments for detection of emergency situations. The aim of this study was to deliver a proof-of-concept for the use of multimodal sensor systems with pervasive computing technology for the detection of clinically relevant health problems over longer time periods. Methods: Data were collected with a longitudinal home monitoring study in Switzerland (StrongAge Cohort Study) in a cohort of 24 old and oldest-old, community-dwelling adults over a period of 1 to 2 years. Physical activity in the apartment, toilet visits, refrigerator use, and entrance door openings were quantified using a commercially available passive infrared motion sensing system (Domosafety S.A., Switzerland). Heart rate, respiration rate, and sleep quality were recorded with the commercially available EMFIT QS bed sensor device (Emfit Ltd., Finland). Vital signs and contextual data were collected using a wearable sensor on the upper arm (Everion, Biovotion, Switzerland). Sensor data were correlated with health-related data collected from the weekly visits of the seniors by health professionals, including information about physical, psychological, cognitive, and behavior status, health problems, diseases, medication, and medical diagnoses. Results: Twenty of the 24 recruited participants (age 88.9 ± 7.5 years, 79% females) completed the study; two participants had to stop their study participation because of severe health deterioration, whereas two participants died during the course of the study. A history of chronic disease was present in 12/24 seniors, including heart failure, heart rhythm disturbances, pulmonary embolism, severe insulin-dependent diabetes, and Parkinson's disease. In total, 242,232 person-hours were recorded. During the monitoring period, 963 health status records were reported and repeated clinical assessments of aging-relevant indicators and outcomes were performed. Several episodes of health deterioration, including heart failure worsening and heart rhythm disturbances, could be captured by sensor signals from different sources. Conclusions: Our results indicate that monitoring of seniors with a multimodal sensor and pervasive computing system over longer time periods is feasible and well-accepted, with a great potential for detection of health deterioration. Further studies are necessary to evaluate the full range of the clinical potential of these findings.

Parkinson&rsquo, s disease (PD) is characterized by a highly individual disease-profile as well as fluctuating symptoms. Consequently, 24-h home monitoring in a real-world environment would be an ideal solution for precise symptom diagnostics. In recent years, small lightweight sensors which have assisted in objective, reliable analysis of motor symptoms have attracted a lot of attention. While technical advances are important, patient acceptance of such new systems is just as crucial to increase long-term adherence. So far, there has been a lack of long-term evaluations of PD-patient sensor adherence and acceptance. In a pilot study of PD patients (N = 4), adherence (wearing time) and acceptance (questionnaires) of a multi-part sensor set was evaluated over a 4-week timespan. The evaluated sensor set consisted of 3 body-worn sensors and 7 at-home installed ambient sensors. After one month of continuous monitoring, the overall system usability scale (SUS)-questionnaire score was 71.5%, with an average acceptance score of 87% for the body-worn sensors and 100% for the ambient sensors. On average, sensors were worn 15 h and 4 min per day. All patients reported strong preferences of the sensor set over manual self-reporting methods. Our results coincide with measured high adherence and acceptance rate of similar short-term studies and extend them to long-term monitoring.