The Design, Development and Validation of a Wearable Behaviour Monitor for the Autonomous Assessment of the Functional Health of Older Adults
Lowe, Shane Alan
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Functional ability describes a person's capability to perform those tasks that are necessary to live independently. It is a proven predictor of functional decline, the need for hospitalisation and institutionalisation and for morbidity and mortality. For this reason, assessment of functional ability has been integrated into standard geriatric care. These assessments are typically performed using questionnaires or observation of the patient and rarely integrate information and communications technology. Devices that monitor a person's performance of activities of daily living have begun to be introduced but have not gained widespread traction in clinical assessment practice. This thesis describes the development and validation of a wearable device for the contextualised monitoring of the performance of activities of daily living. This device is specifically designed to be useful in the domain of functional assessment. Algorithms to combine a range of parameters monitored by the device into a clinically meaningful output are developed and validated. This output is designed to require the minimum possible change in clinical practice. The set of studies described in this thesis test the validity of the data generated by the device in terms of sensitivity and specificity. This testing was performed by comparing device output with video of participants performing activities of daily living in real time. The algorithms used to generate clinically meaningful data were validated in comparison to conventional questionnaire based assessments. Data were also collected on older adults wearing the device in an assisted living facility over a two week period. Results indicated that the device developed in this thesis is an accurate platform for the monitoring of activities of daily living. The data regarding outputs for functional health assessment indicate that the device may perform valid assessments for three different domains of functional health i.e Mobility, Disability and Risk of hospitalisation. Furthermore participants indicated that with slight modifications the device would be acceptable for long term use.