Ageing-friendly cities for assessing older adults' decline: IoT-based system for continuous monitoring of frailty risks using smart city infrastructure.

BACKGROUND AND AIMS: Population ageing is a typical phenomenon of developed countries with a great influence in their economy and society, with an increment on age-related expenditures. Disruptive solutions are needed to deploy new cost-effective and sustainable solutions for aging well and independent living of our seniors. In this sense, new technological paradigms as IoT technologies and smart cities have the potential to become main drivers for innovation uptake. The purpose of this study is to describe a longitudinal cohort study in smart cities for assessing early frailty symptoms deploying an unobtrusive IoT-based system in the Madrid city. METHODS: A system was deployed in the Madrid city with the participation of 45 elderly users for an average of 71 weeks. Metrics were assessed by the available sensors in combination with the open data infrastructure of Madrid. Metrics include activity of the user, weekly visits pattern and transport daily usage pattern. System engagement was also monitored. Participants are assessed bimonthly with health and functional questionnaires. RESULTS: 45 older adults with a mean age of 79.1 years. Participants activity patterns monitor detected changes during potentially risky situations that usually were not reported by traditional assessment tools. Analysis of data collected enabled to identify absence of frailty (robust or post-robust status) DISCUSSION AND CONCLUSIONS: The results demonstrate the feasibility of engaging older adults with an IoT-based system and the successful collection of their activity metrics. Variation in the activity patterns may be a first sign of functional decline and enables to identify potential areas of early intervention.

Evolution of Cognitive Rehabilitation After Stroke From Traditional Techniques to Smart and Personalized Home-Based Information and Communication Technology Systems: Literature Review.

BACKGROUND: Neurological patients after stroke usually present cognitive deficits that cause dependencies in their daily living. These deficits mainly affect the performance of some of their daily activities. For that reason, stroke patients need long-term processes for their cognitive rehabilitation. Considering that classical techniques are focused on acting as guides and are dependent on help from therapists, significant efforts are being made to improve current methodologies and to use eHealth and Web-based architectures to implement information and communication technology (ICT) systems that achieve reliable, personalized, and home-based platforms to increase efficiency and level of attractiveness for patients and carers. OBJECTIVE: The goal of this work was to provide an overview of the practices implemented for the assessment of stroke patients and cognitive rehabilitation. This study puts together traditional methods and the most recent personalized platforms based on ICT technologies and Internet of Things. METHODS: A literature review has been distributed to a multidisciplinary team of researchers from engineering, psychology, and sport science fields. The systematic review has been focused on published scientific research, other European projects, and the most current innovative large-scale initiatives in the area. A total of 3469 results were retrieved from Web of Science, 284 studies from Journal of Medical Internet Research, and 15 European research projects from Community Research and Development Information Service from the last 15 years were reviewed for classification and selection regarding their relevance. RESULTS: A total of 7 relevant studies on the screening of stroke patients have been presented with 6 additional methods for the analysis of kinematics and 9 studies on the execution of goal-oriented activities. Meanwhile, the classical methods to provide cognitive rehabilitation have been classified in the 5 main techniques implemented. Finally, the review has been finalized with the selection of 8 different ICT-based approaches found in scientific-technical studies, 9 European projects funded by the European Commission that offer eHealth architectures, and other large-scale activities such as smart houses and the initiative City4Age. CONCLUSIONS: Stroke is one of the main causes that most negatively affect countries in the socioeconomic aspect. The design of new ICT-based systems should provide 4 main features for an efficient and personalized cognitive rehabilitation: support in the execution of complex daily tasks, automatic error detection, home-based performance, and accessibility. Only 33% of the European projects presented fulfilled those requirements at the same time. For this reason, current and future large-scale initiatives focused on eHealth and smart environments should try to solve this situation by providing more complete and sophisticated platforms.