title: Unobtrusive assessment of activity patterns associated with mild cognitive impairment.
abstract: BACKGROUND
  Timely detection of early cognitive impairment is difficult. Measures taken in the clinic reflect a single snapshot of performance that might be confounded by the increased variability typical in aging and disease. We evaluated the use of continuous, long-term, and unobtrusive in-home monitoring to assess neurologic function in healthy and cognitively impaired elders.
  
  
  METHODS
  Fourteen older adults 65 years and older living independently in the community were monitored in their homes by using an unobtrusive sensor system. Measures of walking speed and amount of activity in the home were obtained. Wavelet analysis was used to examine variance in activity at multiple time scales.
  
  
  RESULTS
  More than 108,000 person-hours of continuous activity data were collected during periods as long as 418 days (mean, 315 +/- 82 days). The coefficient of variation in the median walking speed was twice as high in the mild cognitive impairment (MCI) group (0.147 +/- 0.074) as compared with the healthy group (0.079 +/- 0.027; t(11) = 2.266, P < .03). Furthermore, the 24-hour wavelet variance was greater in the MCI group (MCI, 4.07 +/- 0.14; healthy elderly, 3.79 +/- 0.23; F = 7.58, P </= .008), indicating that the day-to-day pattern of activity of subjects in the MCI group was more variable than that of the cognitively healthy controls.
  
  
  CONCLUSIONS
  The results not only demonstrate the feasibility of these methods but also suggest clear potential advantages to this new methodology. This approach might provide an improved means of detecting the earliest transition to MCI compared with conventional episodic testing in a clinic environment.
authors.affiliation: Department of Biomedical Engineering, Oregon Health & Science University, Portland, OR, USA. hayesta@ohsu.edu
authors.forename: Tamara L
authors.initials: TL
authors.lastname: Hayes
authors.forename: Francena
authors.initials: F
authors.lastname: Abendroth
authors.forename: Andre
authors.initials: A
authors.lastname: Adami
authors.forename: Misha
authors.initials: M
authors.lastname: Pavel
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Zitzelberger
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Kaye
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000503:physiopathology; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D003430:Cross-Sectional Studies; D006801:Humans; D008609:Mental Status Schedule; D009043:Motor Activity / Q000502:physiology; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012111:Residence Characteristics