Kamil Rebecca J, Bakar Dara, Ehrenburg Matthew, Wei Eric X, Pletnikova Alexandra, Xiao Grace, Oh Esther S, Mancini Martina, Agrawal Yuri
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, United States.
Warren Alpert Medical School of Brown University, Providence, RI, United States.
Front Neurol. 2021 Mar 11;12:529661. doi: 10.3389/fneur.2021.529661. eCollection 2021.
Patients with Alzheimer's disease (AD) and AD related dementias (ADRD) often experience spatial disorientation that can lead to wandering behavior, characterized by aimless or purposeless movement. Wandering behavior has been associated with falls, caregiver burden, and nursing home placement. Despite the substantial clinical consequences of wandering, there is currently no standardized approach to objectively quantify wandering behavior. In this pilot feasibility study, we used a lightweight inertial sensor to examine mobility characteristics of a small group of 12 older adults with ADRD and mild cognitive impairment in their homes. Specifically, we evaluated their compliance with wearing a sensor for a minimum of 4 days. We also examined the ability of the sensor to measure turning frequency and direction changes, given that frequent turns and direction changes during walking have been observed in patients who wander. We found that all patients were able to wear the sensor yielding quantitative turn data including number of turns over time, mean turn duration, mean peak turn speed, and mean turn angle. We found that wanderers make more frequent, quicker turns compared to non-wanderers, which is consistent with pacing or lapping behavior. This study provides preliminary evidence that continuous monitoring in patients with dementia is feasible using a wearable sensor. More studies are needed to explore if objective measures of turning behaviors collected using inertial sensors can be used to identify wandering behavior.
患有阿尔茨海默病（AD）及AD相关痴呆症（ADRD）的患者常出现空间定向障碍，这可能导致徘徊行为，其特征为无目的或无意义的移动。徘徊行为与跌倒、照料者负担及入住养老院有关。尽管徘徊行为会产生严重的临床后果，但目前尚无客观量化徘徊行为的标准化方法。在这项初步可行性研究中，我们使用了一种轻便的惯性传感器，来研究一小群12名患有ADRD和轻度认知障碍的老年人在其家中的活动特征。具体而言，我们评估了他们佩戴传感器至少4天的依从性。鉴于在徘徊患者中观察到行走过程中频繁转弯和方向改变，我们还研究了该传感器测量转弯频率和方向改变的能力。我们发现所有患者都能够佩戴传感器，从而产生定量的转弯数据，包括随时间的转弯次数、平均转弯持续时间、平均峰值转弯速度和平均转弯角度。我们发现，与非徘徊者相比，徘徊者转弯更频繁、速度更快，这与踱步或绕圈行为一致。这项研究提供了初步证据，表明使用可穿戴传感器对痴呆患者进行持续监测是可行的。还需要更多研究来探索，使用惯性传感器收集的转弯行为客观测量指标是否可用于识别徘徊行为。
