Detection of activities of daily living impairment in Alzheimer's disease and mild cognitive impairment using information and communication technology.
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 (DAS(AD,P1) = 0.47, 95% confidence interval [CI] 0.38-0.56) from NC (DAS(NC,P1) = 0.71, 95% CI 0.68-0.74). In P2, the DAS score differentiated MCI (DAS(MCI,P2) = 0.11, 95% CI 0.05-0.16) and NC (DAS(NC,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.
['Sacco|Guillaume|G|', 'Joumier|Véronique|V|', 'Darmon|Nelly|N|', 'Dechamps|Arnaud|A|', 'Derreumaux|Alexandre|A|', 'Lee|Ji-Hyun|JH|', 'Piano|Julie|J|', 'Bordone|Nathalie|N|', 'Konig|Alexandra|A|', 'Teboul|Bernard|B|', 'David|Renaud|R|', 'Guerin|Olivier|O|', 'Bremond|François|F|', 'Robert|Philippe|P|']
D000203:Activities of Daily Living D000368:Aged D000369:Aged, 80 and over D000544:Alzheimer Disease D060825:Cognitive Dysfunction D005260:Female D006699:Home Care Services D006801:Humans D008297:Male D009483:Neuropsychological Tests D017216:Telemedicine D014741:Video Recording
MCI ICT IADL functional impairment