Sensor-based assessment of mobility-related behavior in dementia: Feasibility and relevance in a hospital context

Background: The assessment of patients' motor behavior is a key challenge in dementia care. Common geriatric assessment questionnaires or actigraphy measurements often lack methodological quality and are unsuitable to individually tailor interventions. Hence, there is a need for developing objective tools to assess patterns of motor behavior. Therefore, the feasibility of a sensor-based assessment of mobility-related behavior in patients with dementia is investigated. Methods: A cross-sectional investigation on three dementia care wards in a psychiatric hospital was conducted. Forty-five patients with stages of dementia were included. Hybrid motion sensors, recording the sequence of body-postures, were attached on the patients' lower back for 72 consecutive hours. Results: Eighty-nine percent of the assessment periods were completed. On average patients spent 10.9 h/day lying (45%), 9.7 h/day sedentary while sitting or standing (41%), 1.7 h/day active while sitting or standing (7%), 1.7 h/day walking (7%), and reached on average 8,829 steps per day (SD = 7,428). Though overall activity levels were low, the results indicate a wide spectrum of activity patterns - ranging from almost inactive to highly active with general restlessness and wandering behavior. Conclusion: The excellent adherence to the assessment protocol compared to wrist-worn actigraphy and the consistency of the sensor-derived analyses with clinical observations are pivotal findings of this study. These results show that it is possible to acquire objective data on individual motor behavior of patients suffering from dementia. This information is essential for tailoring the therapeutic management of these patients in a hospital context.