Automated sensor-based detection of challenging behaviors in advanced stages of dementia in nursing homes.

INTRODUCTION: Sensor-based assessment of challenging behaviors in dementia may be useful to support caregivers. Here, we investigated accelerometry as tool for identification and prediction of challenging behaviors. METHODS: We set up a complex data recording study in two nursing homes with 17 persons in advanced stages of dementia. Study included four-week observation of behaviors. In parallel, subjects wore sensors 24 h/7 d. Participants underwent neuropsychological assessment including MiniMental State Examination and Cohen-Mansfield Agitation Inventory. RESULTS: We calculated the accelerometric motion score (AMS) from accelerometers. The AMS was associated with several types of agitated behaviors and could predict subject's Cohen-Mansfield Agitation Inventory values. Beyond the mechanistic association between AMS and behavior on the group level, the AMS provided an added value for prediction of behaviors on an individual level. DISCUSSION: We confirm that accelerometry can provide relevant information about challenging behaviors. We extended previous studies by differentiating various types of agitated behaviors and applying long-term measurements in a real-world setting.

Time and Memory Efficient Online Piecewise Linear Approximation of Sensor Signals.

Piecewise linear approximation of sensor signals is a well-known technique in the fields of Data Mining and Activity Recognition. In this context, several algorithms have been developed, some of them with the purpose to be performed on resource constrained microcontroller architectures of wireless sensor nodes. While microcontrollers are usually constrained in computational power and memory resources, all state-of-the-art piecewise linear approximation techniques either need to buffer sensor data or have an execution time depending on the segment’s length. In the paper at hand, we propose a novel piecewise linear approximation algorithm, with a constant computational complexity as well as a constant memory complexity. Our proposed algorithm’s worst-case execution time is one to three orders of magnitude smaller and its average execution time is three to seventy times smaller compared to the state-of-the-art Piecewise Linear Approximation (PLA) algorithms in our experiments. In our evaluations, we show that our algorithm is time and memory efficient without sacrificing the approximation quality compared to other state-of-the-art piecewise linear approximation techniques, while providing a maximum error guarantee per segment, a small parameter space of only one parameter, and a maximum latency of one sample period plus its worst-case execution time.

Multidimensional assessment of challenging behaviors in advanced stages of dementia in nursing homes-The insideDEM framework.

INTRODUCTION: Assessment of challenging behaviors in dementia is important for intervention selection. Here, we describe the technical and experimental setup and the feasibility of long-term multidimensional behavior assessment of people with dementia living in nursing homes. METHODS: We conducted 4 weeks of multimodal sensor assessment together with real-time observation of 17 residents with moderate to very severe dementia in two nursing care units. Nursing staff received extensive training on device handling and measurement procedures. Behavior of a subsample of eight participants was further recorded by videotaping during 4 weeks during day hours. Sensors were mounted on the participants' wrist and ankle and measured motion, rotation, as well as surrounding loudness level, light level, and air pressure. RESULTS: Participants were in moderate to severe stages of dementia. Almost 100% of participants exhibited relevant levels of challenging behaviors. Automated quality control detected 155 potential issues. But only 11% of the recordings have been influenced by noncompliance of the participants. Qualitative debriefing of staff members suggested that implementation of the technology and observation platform in the routine procedures of the nursing home units was feasible and identified a range of user- and hardware-related implementation and handling challenges. DISCUSSION: Our results indicate that high-quality behavior data from real-world environments can be made available for the development of intelligent assistive systems and that the problem of noncompliance seems to be manageable. Currently, we train machine-learning algorithms to detect episodes of challenging behaviors in the recorded sensor data.

Accuracy of a custom physical activity and knee angle measurement sensor system for patients with neuromuscular disorders and gait abnormalities.

Long-term assessment of ambulatory behavior and joint motion are valuable tools for the evaluation of therapy effectiveness in patients with neuromuscular disorders and gait abnormalities. Even though there are several tools available to quantify ambulatory behavior in a home environment, reliable measurement of joint motion is still limited to laboratory tests. The aim of this study was to develop and evaluate a novel inertial sensor system for ambulatory behavior and joint motion measurement in the everyday environment. An algorithm for behavior classification, step detection, and knee angle calculation was developed. The validation protocol consisted of simulated daily activities in a laboratory environment. The tests were performed with ten healthy subjects and eleven patients with multiple sclerosis. Activity classification showed comparable performance to commercially available activPAL sensors. Step detection with our sensor system was more accurate. The calculated flexion-extension angle of the knee joint showed a root mean square error of less than 5° compared with results obtained using an electro-mechanical goniometer. This new system combines ambulatory behavior assessment and knee angle measurement for long-term measurement periods in a home environment. The wearable sensor system demonstrated high validity for behavior classification and knee joint angle measurement in a laboratory setting.

Computational state space models for activity and intention recognition. A feasibility study.

BACKGROUND: Computational state space models (CSSMs) enable the knowledge-based construction of Bayesian filters for recognizing intentions and reconstructing activities of human protagonists in application domains such as smart environments, assisted living, or security. Computational, i. e., algorithmic, representations allow the construction of increasingly complex human behaviour models. However, the symbolic models used in CSSMs potentially suffer from combinatorial explosion, rendering inference intractable outside of the limited experimental settings investigated in present research. The objective of this study was to obtain data on the feasibility of CSSM-based inference in domains of realistic complexity. METHODS: A typical instrumental activity of daily living was used as a trial scenario. As primary sensor modality, wearable inertial measurement units were employed. The results achievable by CSSM methods were evaluated by comparison with those obtained from established training-based methods (hidden Markov models, HMMs) using Wilcoxon signed rank tests. The influence of modeling factors on CSSM performance was analyzed via repeated measures analysis of variance. RESULTS: The symbolic domain model was found to have more than 10(8) states, exceeding the complexity of models considered in previous research by at least three orders of magnitude. Nevertheless, if factors and procedures governing the inference process were suitably chosen, CSSMs outperformed HMMs. Specifically, inference methods used in previous studies (particle filters) were found to perform substantially inferior in comparison to a marginal filtering procedure. CONCLUSIONS: Our results suggest that the combinatorial explosion caused by rich CSSM models does not inevitably lead to intractable inference or inferior performance. This means that the potential benefits of CSSM models (knowledge-based model construction, model reusability, reduced need for training data) are available without performance penalty. However, our results also show that research on CSSMs needs to consider sufficiently complex domains in order to understand the effects of design decisions such as choice of heuristics or inference procedure on performance.