Self-monitoring of physical frailty : a proactive approach in community-dwelling elderly people

Abstract

The main objective of the dissertation was to develop and evaluate a self-monitoring and feedback system that can be used by community-dwelling elderly people to gain insight into (changes in) indicators of physical frailty that are predictors of increased risk of disability. To achieve this, the following research questions were addressed: 1) What is the predictive value of physical frailty indicators on disability in community-dwelling elderly people?, 2) Can simple, innovative technologies be used to obtain valid and reliable estimates of physical frailty indicators?, and 3) How can simple, innovative technologies be integrated into a self-monitoring system that provides regular feedback to elderly people regarding (changes in) physical frailty indicators? The studies described in the dissertation show that physical frailty indicators (e.g., physical activity, weight, grip strength, balance) are predictive of disability development in community-dwelling elderly people. Simple, innovative technologies that can be used by elderly people to obtain valid and reliable estimates of these indicators are a bathroom scale that can measure weight and balance, a Grip-ball that can measure grip strength, and a smartphone that can measure the amount of daily physical activity. These devices were incorporated into a self-monitoring and feedback system during a user-centered design process. Small scale usability tests and a pilot study show that the system satisfied most needs of the end users and, despite a few technical errors, elderly people considered the system easy-to use which resulted in good adherence to the daily monitoring regimen. Keywordsfrailty; elderly people; physical functioning, telemonitoring; self-management