Evaluating changes in gait and activity associated with cognitive impairment using a home-based technology platform

Neil W. Thomas, Ashi Agarwal, Laura Ault, Julien Lariviere-Chartier, Lysa Legault Kingstone, Bruce Wallace, Frank Knoefel, Rafik Goubran, Zachary Beattie, Jeffrey A. Kaye

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


BACKGROUND: Changes in mobility are associated with cognitive decline in older adults. Mobility is frequently assessed in the clinic setting at episodic intervals. Passive sensors within a home-based technology platform allow for unobtrusive collection of mobility and gait information over an extended time period. This method of high-frequency data collection could be sensitive to early changes in mobility associated with cognitive decline. METHOD: We present data for a cohort of 32 participants living alone and enrolled in the Collaborative Aging Research Using Technology (CART) Initiative aging study with a pervasive sensing and computing system deployed in their homes. Sixteen individuals with a Clinical Dementia Rating (CDR) scale score of 0.5 were matched by age, sex and education to 16 participants with a CDR of 0; 80% lived in low-income senior apartments; 6% were non-white. Mobility and gait data is derived from a gait line, consisting of four ceiling mounted, field-of-view restricted passive infrared motion sensors placed 61 cm apart in a line, in each home. The number of walking events, defined as all four sensors being triggered, was analyzed between the two groups. RESULT: Participants with a CDR score of 0 had a mean age of 72.1 years and a mean MoCA score of 26.1 (range 21 - 30). Participants with a CDR score of 0.5 had a mean age of 72.2 and a mean MoCA score of 22.1 (range 15 - 27). Fifty-six percent of participants in each group were female. Preliminary data from the gait line from a combined 1400 days for CDR 0 participants and a combined 1250 days for CDR 0.5 participants is presented here. The mean number of daily walking events detected by the gait line was significantly greater for CDR 0 participants (101.4) compared to CDR 0.5 participants (92.8, p=0.03). CONCLUSION: Ambient sensors are able to collect longitudinal data on gait and activity levels in individuals with a technology platform deployed within their home. This unobtrusive remote mobility assessment methodology identifies individuals experiencing cognitive impairment. Further evaluation of other gait metrics and home-based activity patterns is ongoing to explore their association with changes in cognition.

Original languageEnglish (US)
Pages (from-to)e056085
JournalAlzheimer's & dementia : the journal of the Alzheimer's Association
StatePublished - Dec 1 2021

ASJC Scopus subject areas

  • Clinical Neurology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Health Policy
  • Developmental Neuroscience
  • Epidemiology


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