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Detection of activities of daily living impairment in Alzheimer's disease and mild cognitive impairment using information and communication technology

Authors Sacco G , Joumier, Darmon, Dechamps, Derreumaux, Lee, Piano, Bordone, Konig, Teboul, David, Guerin O, Bremond, Robert P

Received 23 July 2012

Accepted for publication 6 September 2012

Published 4 December 2012 Volume 2012:7 Pages 539—549


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 5

Guillaume Sacco,1–3 Véronique Joumier,1,4 Nelly Darmon,1 Arnaud Dechamps,1,5 Alexandre Derreumaux,1,3 Ji-Hyun Lee,2 Julie Piano,2 Nathalie Bordone,2 Alexandra Konig,1,6 Bernard Teboul,3 Renaud David,1,2 Olivier Guerin,1,3 François Bremond,1,4 Philippe Robert1,2

EA CoBTeK, Université de Nice Sophia-Antipolis, 2Centre Mémoire de Ressource et de Recherche, CHU de Nice, 3Plateforme Patient du Centre d'Innovation et d'Usage en Santé, CHU de Nice, 4Equipe Stars, Institut National de Recherche en Informatique et en Automatique (INRIA), Sophia-Antipolis, France; 5University of Pancasila, Department of Psychology, Jakarta, Indonesia; 6University of Maastricht, Faculty of Psychology and Neuropsychology, Department of Psychiatry and Neuropsychology, Maastricht, The Netherlands

Background: One of the key clinical features of Alzheimer's disease (AD) is impairment in daily functioning. Patients with mild cognitive impairment (MCI) also commonly have mild problems performing complex tasks. Information and communication technology (ICT), particularly techniques involving imaging and video processing, is of interest in order to improve assessment. The overall aim of this study is to demonstrate that it is possible using a video monitoring system to obtain a quantifiable assessment of instrumental activities of daily living (IADLs) in AD and in MCI.
Methods: The aim of the study is to propose a daily activity scenario (DAS) score that detects functional impairment using ICTs in AD and MCI compared with normal control group (NC). Sixty-four participants over 65 years old were included: 16 AD matched with 10 NC for protocol 1 (P1) and 19 MCI matched with 19 NC for protocol 2 (P2). Each participant was asked to undertake a set of daily tasks in the setting of a “smart home” equipped with two video cameras and everyday objects for use in activities of daily living (8 IADLs for P1 and 11 for P2, plus 4 temporal execution constraints). The DAS score was then computed from quantitative and qualitative parameters collected from video recordings.
Results: In P1, the DAS score differentiated AD (DASAD,P1 = 0.47, 95% confidence interval [CI] 0.38–0.56) from NC (DASNC,P1 = 0.71, 95% CI 0.68–0.74). In P2, the DAS score differentiated MCI (DASMCI,P2 = 0.11, 95% CI 0.05–0.16) and NC (DASNC,P2 = 0.36, 95% CI 0.26–0.45).
Conclusion: In conclusion, this study outlines the interest of a novel tool coming from the ICT world for the assessment of functional impairment in AD and MCI. The derived DAS scores provide a pragmatic, ecological, objective measurement which may improve the prediction of future dementia, be used as an outcome measurement in clinical trials and lead to earlier therapeutic intervention.

Keywords: functional impairment, ICT, IADL, MCI

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