The Toronto older adults gait archive: video and 3D inertial motion capture data of older adults' walking.

We introduce the Toronto Older Adults Gait Archive, a gait dataset of 14 older adults containing 2D video recordings, and 2D (video pose tracking algorithms) and 3D (inertial motion capture) joint locations of the lower body. Participants walked for 60 seconds. We also collected participants' scores on four clinical assessments of gait and balance, namely the Tinneti performance-oriented mobility assessment (POMA-gait and -balance), the Berg balance scale (BBS), and the timed-up-and-go (TUG). Three human pose tracking models (Alphapose, OpenPose, and Detectron) were used to detect body joint positions in 2D video frames and a number of gait parameters were computed using 2D video-based and 3D motion capture data. To show an example usage of our datasets, we performed a correlation analysis between the gait variables and the clinical scores. Our findings revealed that the temporal but not the spatial or variability gait variables from both systems had high correlations to clinical scores. This dataset can be used to evaluate, or to enhance vision-based pose-tracking models to the specifics of older adults' walking.

Concurrent validity of human pose tracking in video for measuring gait parameters in older adults: a preliminary analysis with multiple trackers, viewing angles, and walking directions.

BACKGROUND: Many of the available gait monitoring technologies are expensive, require specialized expertise, are time consuming to use, and are not widely available for clinical use. The advent of video-based pose tracking provides an opportunity for inexpensive automated analysis of human walking in older adults using video cameras. However, there is a need to validate gait parameters calculated by these algorithms against gold standard methods for measuring human gait data in this population. METHODS: We compared quantitative gait variables of 11 older adults (mean age = 85.2) calculated from video recordings using three pose trackers (AlphaPose, OpenPose, Detectron) to those calculated from a 3D motion capture system. We performed comparisons for videos captured by two cameras at two different viewing angles, and viewed from the front or back. We also analyzed the data when including gait variables of individual steps of each participant or each participant's averaged gait variables. RESULTS: Our findings revealed that, i) temporal (cadence and step time), but not spatial and variability gait measures (step width, estimated margin of stability, coefficient of variation of step time and width), calculated from the video pose tracking algorithms correlate significantly to that of motion capture system, and ii) there are minimal differences between the two camera heights, and walks viewed from the front or back in terms of correlation of gait variables, and iii) gait variables extracted from AlphaPose and Detectron had the highest agreement while OpenPose had the lowest agreement. CONCLUSIONS: There are important opportunities to evaluate models capable of 3D pose estimation in video data, improve the training of pose-tracking algorithms for older adult and clinical populations, and develop video-based 3D pose trackers specifically optimized for quantitative gait measurement.

Ecological Momentary Assessment of Depression in People With Advanced Dementia: Longitudinal Pilot Study.

BACKGROUND: Barriers to assessing depression in advanced dementia include the presence of informant and patient recall biases. Ecological momentary assessment provides an improved approach for mood assessment by collecting observations in intervals throughout the day, decreasing recall bias, and increasing ecological validity. OBJECTIVE: This study aims to evaluate the feasibility, reliability, and validity of the modified 4-item Cornell Scale for Depression in Dementia for Momentary Assessment (mCSDD4-MA) tool to assess depression in patients with advanced dementia. METHODS: A intensive longitudinal pilot study design was used. A total of 12 participants with advanced dementia were enrolled from an inpatient psychogeriatric unit. Participants were assessed using clinical depression assessments at admission and discharge. Research staff recorded observations four times a day for 6 weeks on phones with access to the mCSDD4-MA tool. Descriptive data related to feasibility were reported (ie, completion rates). Statistical models were used to examine the interrater reliability and construct and predictive validity of the data. RESULTS: Overall, 1923 observations were completed, representing 55.06% (1923/3496) of all rating opportunities with 2 raters and 66.01% (1923/2913) with at least one rater. Moderate interrater reliability was demonstrated for all items, except for lack of interest. Moderate correlations were observed between observers and patient-reported outcomes, where observers reported fewer symptoms relative to participants' self-reports. Several items were associated with and able to predict depression. CONCLUSIONS: The mCSDD4-MA tool was feasible to use, and most items in the tool showed moderate reliability and validity for assessing depression in dementia. Repeated and real-time depression assessment in advanced dementia holds promise for the identification of clinical depression and depressive symptoms.

Screening for depression in older adults with cognitive impairment in the homecare setting: a systematic review.

OBJECTIVE: Previous systematic reviews have examined depression screening in older adults with cognitive impairment (CI) in outpatient and inpatient clinics, nursing homes, and residential care. Despite an increasing number of older adults with CI receiving care in their homes, less is known about best depression screening practices in homecare. The objective of this review is to identify evidence-based practices for depression screening for individuals with CI receiving homecare by assessing tool performance and establishing the current evidence for screening practices in this setting. METHODS: This review is registered under PROSPERO (ID: CRD42018110243). A systematic search was conducted using MEDLINE, EMBASE, Health and Psychosocial Abstracts, PsycINFO and CINAHL. The following criteria were used: assessment of depression at home in older adults (>55 years) with CI, where performance outcomes of the depression screening tool were reported. RESULTS: Of 5,453 studies, only three met eligibility criteria. These studies evaluated the Patient Health Questionnaire (n = 236), the Geriatric Depression Scale (n = 79) and the Mental Health Index (n = 1,444) in older adults at home with and without CI. Psychometric evaluation demonstrated moderate performance in the subsamples of people with CI. CONCLUSION: At present, there is insufficient evidence to support best practices in screening for depression in people with CI in homecare.

Efficacy and Generalizability of Falls Prevention Interventions in Nursing Homes: A Systematic Review and Meta-analysis.

OBJECTIVES: To determine the efficacy of fall intervention programs in nursing homes (NHs) and the generalizability of these interventions to people living with cognitive impairment and dementia. DESIGN: Systematic review and meta-analysis. SETTING AND PARTICIPANTS: NH residents (n = 30,057) living in NHs defined as residential facilities that provide 24-hours-a-day surveillance, personal care, and some clinical care for persons who are typically aged ≥65 years with multiple complex chronic health conditions. METHODS: Meta-analysis of falls prevention interventions on number of falls, fallers, and recurrent fallers. RESULTS: Thirty-six studies met inclusion criteria for the systematic review. Overall, fall prevention interventions reduced the number of falls [risk ratio (RR) = 0.73, 95% confidence interval (CI) = 0.60-0.88], fallers (RR = 0.80, 95% CI = 0.72-0.89), and recurrent fallers (RR = 0.70, 95% CI = 0.60-0.81). Subanalyses revealed that single interventions have a significant effect on reducing fallers (RR = 0.78, 95% CI = 0.69-0.89) and recurrent fallers (RR = 0.60, 95% CI = 0.52-0.70), whereas multiple interventions reduce fallers (RR = 0.69, 95% CI = 0.39-0.97) and multifactorial interventions reduce number of falls (RR = 0.65, 95% CI = 0.45-0.94). CONCLUSIONS AND IMPLICATIONS: Exercise as a single intervention reduced the number of fallers and recurrent fallers by 36% and 41%, respectively, in people living in NHs. Other effective interventions included staff education and multiple and multifactorial interventions. However, more research on exercise including people with cognitive impairment and dementia is needed to improve the generalizability of these interventions to the typical NH resident.