Abstract
Ubiquity (devices becoming part of the context) and transparency (devices not interfering with daily activities) are very significant in healthcare monitoring applications for elders. The present study undertakes a scoping review to map the literature on sensor-based unobtrusive monitoring of older adults’ frailty. We aim to determine what types of devices comply with unobtrusiveness requirements, which frailty markers have been unobtrusively assessed, which unsupervised devices have been tested, the relationships between sensor outcomes and frailty markers, and which devices can assess multiple markers. SCOPUS, PUBMED, and Web of Science were used to identify papers published 2010–2020. We selected 67 documents involving non-hospitalized older adults (65+ y.o.) and assessing frailty level or some specific frailty-marker with some sensor. Among the nine types of body worn sensors, only inertial measurement units (IMUs) on the waist and wrist-worn sensors comply with ubiquity. The former can transparently assess all variables but weight loss. Wrist-worn devices have not been tested in unsupervised conditions. Unsupervised presence detectors can predict frailty, slowness, performance, and physical activity. Waist IMUs and presence detectors are the most promising candidates for unobtrusive and unsupervised monitoring of frailty. Further research is necessary to give specific predictions of frailty level with unsupervised waist IMUs.
Highlights
Disability is one of the major challenges for elderly care
The present review aims to identify which sensing approaches comply with ubiquity and transparency requirements and are suitable to be used in unsupervised conditions
Forty-three of them came from citations previously identified by the review team, and 25 of them came from scanning the list of reference of the studies included for analysis in subsequent stages of the review
Summary
Even though people live longer, they are expected to spend many years dealing with disability [1]. The forecast for trends in England and Wales predicts an increase in life expectancy with disability at age 65 from 4.7 years in 2015 to 5.4 years in 2025 [1]. Disability may be preceded by several years by a state of increased vulnerability known as frailty [3]. Frailty is a multidimensional concept involving different biological systems (nervous, endocrine, immune, and musculoskeletal) [4]. It makes homeostasis difficult even when a frail person is exposed to low power stressors [4]. Frailty is an end point of many different pathways (e.g., similar to the different aetiologias of heart failure—ischemic, cardiomyopathic, etc.)
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