In-Home Positioning for Remote Home Health Monitoring in Older Adults: Systematic Review (Preprint)

Abstract

BACKGROUND With the growing proportion of Canadians over 65 years old, smart home and health monitoring technologies may help older adults to manage chronic disease and support aging-in-place. Localization technologies have been used to support management of frailty and dementia by detecting activities in the home. OBJECTIVE This systematic review aims to summarize the clinical evidence for in-home localization technologies, review the acceptability of monitoring, and summarize the range of technologies being used for in-home localization. METHODS PRISMA methodology was followed and the protocol was registered with PROSPERO. MEDLINE, EMBASE, CINAHL and Scopus were searched with two reviewers performing screening, extractions and quality assessments. RESULTS A total of 1935 articles were found, with 36 technology-focused articles and 10 that reported on patient outcomes. From moderate to high quality studies, two studies reported mixed results on identifying mild cognitive dementia or frailty, while four studies reported mixed results on acceptability of localization technology. Technologies included ambient sensors, Bluetooth or Wifi received signal strength to localizer tags using RFID, UWB, Zigbee or GPS, and inertial measurement units with localizer tags. CONCLUSIONS Clinical utility of localization remains mixed, with in-home sensors not being able to identify between older adults with healthy cognition from older adults with mild cognitive impairment. However, frailty was detectable using in-home sensors. Acceptability is moderately positive, particularly with ambient sensors. Localization technologies can achieve room detection accuracies up to 92% and linear accuracies of up to 5-20cm that may be promising for future clinical applications. CLINICALTRIAL PROSPERO (ID:CRD 42022339845)